Individual
DOMONIQUE SHANTAE BECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
138 OLD SAN ANTONIO RD STE 304, BOERNE, TX 78006-3491
(210) 419-3144
(210) 764-5098
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-07109
KS
225100000X
Physical Therapist
Primary
1359208
TX
225100000X
Physical Therapist
PT013764
GA
Other
Enumeration date
11/02/2018
Last updated
08/15/2022
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