Individual
MASON I BEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 WOODKNOLL DR APT 1006, GRANGER, IN 46530-4922
(574) 835-0094
Mailing address
314 WOODKNOLL DR APT 1006, GRANGER, IN 46530-4922
(574) 835-0094
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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