Provider Demographics
NPI:1902188097
Name:BELTRAME, JACQUELINE (PT,DPT)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:BELTRAME
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 1:2001 WESTOWN PKWY
Mailing Address - Street 2:STE 107
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1540
Mailing Address - Country:US
Mailing Address - Phone:515-440-3439
Mailing Address - Fax:515-440-3832
Practice Address - Street 1:516 NILE KINNICK DR S
Practice Address - Street 2:STE B
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-2076
Practice Address - Country:US
Practice Address - Phone:515-993-5599
Practice Address - Fax:515-993-1964
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2016027014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist