Individual
JOHN BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
134 PATRIOT LN, SUMMERVILLE, SC 29483-1889
(843) 963-6674
Mailing address
134 PATRIOT LN, SUMMERVILLE, SC 29483-1889
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
05/09/2012
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