Individual
THERESA K BEALS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2600 HAYES AVENUE, SANDUSKY, OH 44870
(419) 625-6181
(419) 625-7493
Mailing address
PO BOX 2238, SANDUSKY, OH 44871
(419) 625-6181
(419) 625-7493
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3780
OH
152W00000X
Optometrist
T350
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0765300
—
OH
Enumeration date
03/29/2006
Last updated
07/08/2007
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