Provider Demographics
NPI:1134868698
Name:BEACHNAU, GUY P (PT)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:P
Last Name:BEACHNAU
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4048 CEDAR BLUFF DR STE 2
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8895
Mailing Address - Country:US
Mailing Address - Phone:231-347-5120
Mailing Address - Fax:231-347-4844
Practice Address - Street 1:8452 M 119
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-9595
Practice Address - Country:US
Practice Address - Phone:231-348-7002
Practice Address - Fax:231-348-7009
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501301888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501301888OtherSTATE OF MICHIGAN