Individual
SANDRA PATRICK BEASOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1591 HINES RD, BOONVILLE, NY 13309-2108
(315) 942-3101
Mailing address
1591 HINES RD, BOONVILLE, NY 13309-2108
(315) 942-3101
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
008822-1
NY
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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