Individual
SETH BEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 COLOMA DR, MISSOULA, MT 59801-7083
(216) 338-7838
Mailing address
1110 COLOMA DR, MISSOULA, MT 59801-7083
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
AT
MT
Enumeration date
07/09/2017
Last updated
07/09/2017
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