Individual
MR. THOMAS ANTHONY-MARTIN BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
12704 NORTHLAND DR, CEDAR SPRINGS, MI 49319-8452
(616) 292-4573
Mailing address
12704 NORTHLAND DR, CEDAR SPRINGS, MI 49319-8452
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5502002747
MI
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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