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Individual

BENJAMIN BECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT

Contact information

Practice address
621 SCIENCE DR, MADISON, WI 53711-1074
(608) 890-8565
Mailing address
1427 WILD IRIS ST, SUN PRAIRIE, WI 53590-7040

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1075-39
WI

Other

Enumeration date
02/09/2015
Last updated
02/09/2015
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