Individual
TARA L BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004040
IA
225100000X
Physical Therapist
6826
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44G03BE
BXBS
MN
Enumeration date
01/30/2006
Last updated
11/26/2008
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