Provider Demographics
NPI:1871671107
Name:BEARY, JOEL (PT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:BEARY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19964 HILLTOP RD STE B
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7317
Mailing Address - Country:US
Mailing Address - Phone:303-840-4667
Mailing Address - Fax:303-840-4658
Practice Address - Street 1:19964 HILLTOP RD STE B
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7317
Practice Address - Country:US
Practice Address - Phone:303-840-4667
Practice Address - Fax:303-840-4658
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008424225100000X
FLPT28160225100000X
CO16135225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist