Provider Demographics
NPI:1386869345
Name:BEEBE, JAMES EDWIN (PT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWIN
Last Name:BEEBE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4415 S RURAL RD
Mailing Address - Street 2:SUITE #11
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7060
Mailing Address - Country:US
Mailing Address - Phone:480-345-2664
Mailing Address - Fax:480-345-8563
Practice Address - Street 1:4415 S RURAL RD
Practice Address - Street 2:SUITE #11
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7060
Practice Address - Country:US
Practice Address - Phone:480-345-2664
Practice Address - Fax:480-345-8563
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZRPT2048Medicare ID - Type UnspecifiedOUTPATIENT PHYSICAL THER