Beach, Mary Lou

Beach, Mary Lou is an individual health care provider with primary practice located at 409 E Front St , Bloomington IL 61701-5309. She recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as her primary health care specialty. Beach, Mary Lou can be contacted via phone (309) 828-3415.

Contact Information

Primary practice address
409 E Front St Bloomington IL 61701-5309
Phone: (309) 828-3415
Fax: (309) 828-2665
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 038-005425 Illinois

Profile Details

NPI number 1013009083
LBN Legal business name Beach, Mary Lou
Credentials D.C., C.C.S.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Sep 28th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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