| Doctor Name: | DR. MARYBETH GRANT-BEUTTLER |
| NPI Number: | 1720062813 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T., PH.D. |
| License Number: | 33373 |
| Business Practice Address: | 19 Skysail Dr Corona Del Mar, CA - 926251437 |
| Business Phone Number: | 9496446460 |
| Business Fax Number: | |
| Mailing Address: | 19 Skysail Dr, CORONA DEL MAR |
| State: | CA |
| Postal Code: | 926251437 |
| Phone Number: | 9496446460 |
| Fax Number: | 5704895563 |
| NPI Enumeration Date: | 12/01/2005 |
| NPI Last Update Date: | 10/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251N0400X |
| License Number: | 33373 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Neurology |
| Taxonomy Definition: | |