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Individual

MR. BRIAN L BEAULIEU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, MPT, OCS,CMTPT

Contact information

Practice address
2004 SANDBRIDGE RD STE 102, VIRGINIA BEACH, VA 23456-4084
(757) 301-6419
(757) 301-6419
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202244
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010097215
VA
01
192967
BCBS PHYSICAL THERAPY
VA
01
7445089
AETNA
01
P00140444
RAILROAD MEDICARE
VA
Enumeration date
04/13/2006
Last updated
04/12/2018
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