Provider Demographics
NPI:1457733685
Name:BEAMAN, MARY MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31738 BURTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARBESON
Mailing Address - State:DE
Mailing Address - Zip Code:19951-2972
Mailing Address - Country:US
Mailing Address - Phone:302-684-5055
Mailing Address - Fax:
Practice Address - Street 1:31738 BURTON DRIVE
Practice Address - Street 2:
Practice Address - City:HARBESON
Practice Address - State:DE
Practice Address - Zip Code:19951-2972
Practice Address - Country:US
Practice Address - Phone:302-684-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10000326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist