Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305205345 | VA |
N | 2251S0007X | Physical Therapist - Sports | 016380 | PA |
N | 2251X0800X | Physical Therapist - Orthopedic | 016380 | PA |
NPI | 1295746865 |
---|---|
Provider Name | Mrs. Susan A Beato |
First Address | Christiansburg, VA 24073-4864 |
Second Address | Christiansburg, VA 24073-4864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 21/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
49-6670 | (02) | VA |