Individual
MR. TED J BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
(770) 701-6675
Mailing address
PO BOX 3570, SALT LAKE CITY, UT 84110-3570
(801) 727-2056
(770) 701-6675
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9423152-3102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
9423152-4406
UT
Other
Enumeration date
02/02/2021
Last updated
03/22/2021
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