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Individual

DR. JACQUES L BEAUCHAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT,DPT,SCS,OCS,ATC

Contact information

Practice address
4216 WASHINGTON RD STE 2, EVANS, GA 30809-4717
(706) 814-5460
(706) 814-5574
Mailing address
PO BOX 5718, KALISPELL, MT 59903-5718
(406) 756-0134
(406) 300-1612

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007231
GA
2255A2300X
Athletic Trainer
AT000993
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
095783718B
GA
Enumeration date
05/04/2006
Last updated
06/09/2021
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