Basic Information
| Provider Information | |||||||||
| NPI: | 1538269196 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEERS | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | LAMAS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43490 YUKON DR | ||||||||
| Address2: | STE 212 | ||||||||
| City: | ASHBURN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201476990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037297920 | ||||||||
| FaxNumber: | 7037297923 | ||||||||
| Practice Location | |||||||||
| Address1: | 43490 YUKON DR | ||||||||
| Address2: | STE 212 | ||||||||
| City: | ASHBURN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201476990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037297920 | ||||||||
| FaxNumber: | 7037297923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2006 | ||||||||
| LastUpdateDate: | 09/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT36017 | CA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 1638 | NE | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 2305210429 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 100502938 | 05 | NV | MEDICAID |