Doctor Name: | MR. JACOB LEE BEAN |
NPI Number: | 1588805907 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | 2352 |
Business Practice Address: | 3155 Channing Way Suite D Idaho Falls, ID - 834047534 |
Business Phone Number: | 2085522700 |
Business Fax Number: | 2085521533 |
Mailing Address: | 1283 N 1130 E, SHELLEY |
State: | ID |
Postal Code: | 832745171 |
Phone Number: | 2083575747 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2009 |
NPI Last Update Date: | 04/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2352 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |