Individual
MARIA NOELLE BEACOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 WASHINGTON ST, PELLA, IA 50219-1553
(641) 628-6728
(641) 628-6727
Mailing address
404 JEFFERSON ST, PELLA, IA 50219-1257
(641) 628-6623
(641) 621-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
107386
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107386
IOWA LICENSE
IA
Enumeration date
01/10/2022
Last updated
01/10/2022
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