Individual
DWAYNE MICHAEL BEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
132 CHANTICLEER DRIVE WEST, CONWAY, SC 29526
(843) 349-2825
(843) 234-3451
Mailing address
3855 CAMDEN DR, MYRTLE BEACH, SC 29588-7858
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
474
SC
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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