Provider Demographics
NPI:1710271366
Name:BEAHM, MEGAN JOELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOELLE
Last Name:BEAHM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-3252
Mailing Address - Country:US
Mailing Address - Phone:620-792-7868
Mailing Address - Fax:
Practice Address - Street 1:4801 10TH ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-3252
Practice Address - Country:US
Practice Address - Phone:620-792-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04245225100000X
IL070.016286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist