Provider Demographics
NPI:1457744948
Name:ALMARIO, BEVERLY TEDTAOTAO (PT)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:TEDTAOTAO
Last Name:ALMARIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:TEDTAOTAO
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40082 EATON ST
Mailing Address - Street 2:APT 102
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4523
Mailing Address - Country:US
Mailing Address - Phone:248-345-4776
Mailing Address - Fax:
Practice Address - Street 1:37501 JOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-7538
Practice Address - Country:US
Practice Address - Phone:734-459-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist