Provider Demographics
NPI:1992937882
Name:KINSLOW, BETH L (MS, LAT)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:L
Last Name:KINSLOW
Suffix:
Gender:F
Credentials:MS, LAT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:L
Other - Last Name:ABEGGLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LAT
Mailing Address - Street 1:2050 4TH AVE
Mailing Address - Street 2:0137 HEC (QUANDT)
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1910
Mailing Address - Country:US
Mailing Address - Phone:715-346-2409
Mailing Address - Fax:
Practice Address - Street 1:2050 4TH AVE
Practice Address - Street 2:040HEC (QUANDT)
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1910
Practice Address - Country:US
Practice Address - Phone:715-346-2409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI581-392083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine