| William T Beverly | |
|
828 W 7th St Walsenburg CO 81089-2315 | |
| (719) 671-7793 | |
| Not Available |
| Full Name | William T Beverly |
|---|---|
| Speciality | Clinic/Center |
| Location | 828 W 7th St, Walsenburg, Colorado |
| Authorized Official Name and Position | William T Beverly (OWNER) |
| Authorized Official Contact | 7196717793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William T Beverly Po Box 871 Walsenburg CO 81089-0871 Ph: (719) 671-7793 | William T Beverly 828 W 7th St Walsenburg CO 81089-2315 Ph: (719) 671-7793 |
| NPI Number | 1720858715 |
|---|---|
| Provider Enumeration Date | 01/02/2024 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 5698118990 |
|---|---|
| Medicare Enrollment ID | O20240202002854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720858715 | NPI | - | NPPES |
| Provider Name | William T Beverly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184930117 PECOS PAC ID: 1557592060 Enrollment ID: I20140326002049 |
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