Individual
JENNA BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4501 MAIN ST STE 5, SHALLOTTE, NC 28470-4585
(910) 755-5863
Mailing address
20 MEDICAL CAMPUS DR NW STE 204, SUPPLY, NC 28462-4094
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
30234
MD
225100000X
Physical Therapist
Primary
CP037335T
NC
Other
Enumeration date
11/21/2024
Last updated
11/21/2024
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