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1164534871
STEPHEN EUGENE BEASLEY
SPRINGFIELD, IL
NPI
1164534871
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070.0003233)
Enumeration Date
2006-08-31
Last Update Date
2007-07-08
Business Address
-- STEPHEN EUGENE BEASLEY pt
320 E. CARPENTER STREET
SPRINGFIELD, IL 62702
Phone number: 217-744-8000
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Mailing Address
-- STEPHEN EUGENE BEASLEY pt
16914 SHIPMAN ROAD
CARLINVILLE, IL 62626-2345
Phone number: 217-854-2410
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