Provider Demographics
NPI:1396137006
Name:HAMMANT, BEVERLY (PT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:HAMMANT
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 1:1307 ARNOLD PALMER CT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-3902
Mailing Address - Country:US
Mailing Address - Phone:575-635-1896
Mailing Address - Fax:
Practice Address - Street 1:1115 COMMERCE DR STE C
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8248
Practice Address - Country:US
Practice Address - Phone:575-525-2450
Practice Address - Fax:575-993-5380
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist