Individual
MS. TIAESHA CHESTANG BEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1515 LACIE DR, TRUSSVILLE, AL 35173-5700
(205) 540-2217
Mailing address
1515 LACIE DR, TRUSSVILLE, AL 35173-5700
(205) 540-2217
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA5105
AL
Other
Enumeration date
04/20/2011
Last updated
03/15/2013
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