Individual
JONATHAN BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
251 S HOFFMAN ST, NASHVILLE, IL 62263-1751
(618) 314-0597
Mailing address
251 S HOFFMAN ST, NASHVILLE, IL 62263-1751
(618) 314-0597
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003823
IL
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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