DWAYNE MICHAEL BEAM

CONWAY, SC
NPI1972602266
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SC  474)
Enumeration Date2006-09-22
Last Update Date2007-07-08
Business Address
-- DWAYNE MICHAEL BEAM ATC
132 CHANTICLEER DRIVE WEST
CONWAY, SC 29526
Phone number: 843-349-2825
Mailing Address
-- DWAYNE MICHAEL BEAM ATC
3855 CAMDEN DR
MYRTLE BEACH, SC 29588-7858
Phone number: