Individual
TINA BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12 KANAWHA TER, SAINT ALBANS, WV 25177-2750
(304) 201-1130
(304) 201-1134
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.004403
OH
363A00000X
Physician Assistant
Primary
712
WV
Other
Enumeration date
08/19/2015
Last updated
01/03/2024
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