Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 003926 | OH |
N | 2081S0010X | Sports Medicine | 003926 | OH |
N | 213ES0000X | Sports Medicine | 003926 | OH |
N | 226300000X | Kinesiotherapist | 003926 | OH |
NPI | 1346756509 |
---|---|
Provider Name | Kayla Beck |
First Address | Monroeville, OH 44847-9707 |
Second Address | Put In Bay, OH 43456-6732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2017 |
Last Update Date | 18/01/2018 |