Individual
RUSTY G BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
340 MENDEL PKWY W, MONTGOMERY, AL 36117-5406
(334) 532-0220
(334) 532-0221
Mailing address
399 MOUNTAIN RIDGE RD, MILLBROOK, AL 36054-2128
(334) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2334
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24EX37RH
BCBS PHYS NUMBER
AL
05
—
890015790
—
AL
Enumeration date
10/13/2006
Last updated
02/11/2015
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