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Individual

VINCENT LEE BEAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.T.,C.

Contact information

Practice address
1480 W 8TH ST, WEST PLAINS, MO 65775-2010
(417) 256-5669
(417) 256-5699
Mailing address
1480 W 8TH ST, WEST PLAINS, MO 65775-2010
(417) 256-5669
(417) 256-5699

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
107041
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107041
ATHLETIC TRAINER
MO
Enumeration date
05/02/2006
Last updated
07/08/2007
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