Provider Demographics
NPI:1063701134
Name:HELM, BEVERLY KAYE (PT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:KAYE
Last Name:HELM
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 1:1401 PHAY AVE
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2303
Mailing Address - Country:US
Mailing Address - Phone:719-275-8656
Mailing Address - Fax:719-275-8858
Practice Address - Street 1:600 DAKOTA LN
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-9275
Practice Address - Country:US
Practice Address - Phone:719-275-8656
Practice Address - Fax:719-275-8858
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist