Individual
MRS. ALICIA JOY BEANBLOSSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
6853 W IRONWOOD DR, PEORIA, AZ 85345-6843
(623) 826-9116
Mailing address
6853 W IRONWOOD DR, PEORIA, AZ 85345-6843
(623) 826-9116
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
03882
IA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
06797
AZ
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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