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Individual
MRS. TRACY JEAN BECK
Active
Individual
MRS. TRACY JEAN BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06398R
LA
225100000X
Physical Therapist
5501013379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F9746
BLUE CROSS BLUE SHIELD
LA
Enumeration date
06/27/2005
Last updated
01/16/2008
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