Individual
MRS. LUCILLE LEVINIA BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT, DO
Contact information
Practice address
155 N UMPQUA ST, SUTHERLIN, OR 97479-9567
(541) 837-1717
Mailing address
PO BOX 8075, COBURG, OR 97408-1301
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-10193177
OR
122400000X
Denturist
DT-TMP-10192123
OR
Other
Enumeration date
06/25/2018
Last updated
07/21/2020
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