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1972602266
DWAYNE MICHAEL BEAM
CONWAY, SC
NPI
1972602266
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SC 474)
Enumeration Date
2006-09-22
Last Update Date
2007-07-08
Business Address
-- DWAYNE MICHAEL BEAM ATC
132 CHANTICLEER DRIVE WEST
CONWAY, SC 29526
Phone number: 843-349-2825
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Mailing Address
-- DWAYNE MICHAEL BEAM ATC
3855 CAMDEN DR
MYRTLE BEACH, SC 29588-7858
Phone number:
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