Provider Demographics
NPI:1558890137
Name:BEECHEY, JAMAL JAMES ROCCO (PT, DPT, EP-C)
Entity Type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:JAMES ROCCO
Last Name:BEECHEY
Suffix:
Gender:M
Credentials:PT, DPT, EP-C
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:710 COMMERCE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4925
Mailing Address - Country:US
Mailing Address - Phone:651-968-5200
Mailing Address - Fax:
Practice Address - Street 1:3580 ARCADE ST STE 150
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-7135
Practice Address - Country:US
Practice Address - Phone:651-968-5600
Practice Address - Fax:651-968-5781
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210889225100000X
MN12266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist