Individual
JERRILYN JUNE BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4237 RIVER HILLS DR, SUITE 120, LITTLE RIVER, SC 29566-6444
(843) 249-5616
Mailing address
4294 PINEHURST CIR, C2, LITTLE RIVER, SC 29566-8368
(843) 455-3698
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
256
SC
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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