Individual
ROBERT MITCHELL BECKSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
675 YELLOWSTONE AVE STE 1, POCATELLO, ID 83201-4511
(208) 478-1488
(208) 478-1498
Mailing address
675 YELLOWSTONE AVE STE 1, POCATELLO, ID 83201-4511
(208) 478-1488
(208) 478-1498
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-5647
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-5647
STATE LICENSE
ID
Enumeration date
05/09/2018
Last updated
05/09/2018
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