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Individual

MR. JOHN MASON BEARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
121 ARCADIA PARK DRIVE, CANTON, GA 30114-4579
(678) 493-6836
Mailing address
121 ARCADIA PARK DR, CANTON, GA 30114-4579
(678) 493-6836

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002325
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT002325
STATE OT LICENSE
GA
Enumeration date
06/25/2007
Last updated
07/08/2007
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