Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | LPT-011748 | AZ |
Y | 2251X0800X | Physical Therapist - Orthopedic | LPT-011748 | AZ |
NPI | 1316509649 |
---|---|
Provider Name | Dr. Samantha Lauren Beeman |
First Address | Tucson, AZ 85742-4857 |
Second Address | Tucson, AZ 85704-7313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2019 |
Last Update Date | 08/07/2019 |