Provider Demographics
NPI:1891804373
Name:BEEBE, SCOTT JEFFREY (AT, C)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:JEFFREY
Last Name:BEEBE
Suffix:
Gender:M
Credentials:AT, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3215 N BC EAST JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-9661
Mailing Address - Country:US
Mailing Address - Phone:231-582-5299
Mailing Address - Fax:231-582-3738
Practice Address - Street 1:197 STATE ST
Practice Address - Street 2:
Practice Address - City:BOYNE CITY
Practice Address - State:MI
Practice Address - Zip Code:49712-1288
Practice Address - Country:US
Practice Address - Phone:231-582-6365
Practice Address - Fax:231-582-3738
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer