Individual
COLBY SHANE BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
601 SEA AVE, EUREKA, CA 95503-1301
(831) 246-0962
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/01/2009
Last updated
07/01/2009
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