Beacon Medical Group, Inc.

NPI #1053864868 in Granger, Indiana

Provider Information

NPI Number: 1053864868
Entity Type: Organization
Organization Name: Beacon Medical Group, Inc.
Primary Specialty: Physical Therapist
Enumeration Date: Jul 28, 2016
Last Updated: Jul 28, 2016

Practice Location

Address: 3221 BEACON PARKWAY
Address 2: SUITE B
City: Granger
State: Indiana
ZIP Code: 46530
Phone: (574) 647-1700

Authorized Official

Name: JEFFREY P COSTELLO
Title: CFO
Phone: (574) 647-3549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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