Individual
MR. MATTHEW THOMAS BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
1126 HEALTHCARE DR, MOUNT CARROLL, IL 61053-1469
(184) 524-4200
Mailing address
616 PALMYRA ST, DIXON, IL 61021-1956
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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