Provider Demographics
NPI:1447204649
Name:MESCH, BEVERLY (ACUPUNCTURE PHYSICIA)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:MESCH
Suffix:
Gender:F
Credentials:ACUPUNCTURE PHYSICIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 VICTORIA DR
Mailing Address - Street 2:UNIT 104
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9597
Mailing Address - Country:US
Mailing Address - Phone:239-945-7880
Mailing Address - Fax:
Practice Address - Street 1:4020 DEL PRADO BLVD S
Practice Address - Street 2:B2
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7175
Practice Address - Country:US
Practice Address - Phone:239-541-0041
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1437171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist