Individual
BEN BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
627 8TH ST, CLERMONT, FL 34711-2159
(352) 243-4422
Mailing address
627 8TH ST, CLERMONT, FL 34711-2159
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28852
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA28852
PHYSICAL THERAPY ASSISTANT LICENSE
FL
Enumeration date
01/24/2019
Last updated
01/24/2019
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