Michael J Beckman

Individual provider Active NPI Athletic Trainer · Greenfield, WI

NPI 1043880495 · NPPES record last updated Jun 28, 2021

Key facts

NPI
1043880495
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2000041218 (WI)
Practice address
4021 S 96TH St
Greenfield, WI 53228-2168
Phone
(414) 949-1453
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2000041218WIMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000041218 WI Yes

Addresses

Primary practice location

4021 S 96TH St
Greenfield, WI 53228-2168

Mailing address

4021 S 96TH St
Greenfield, WI 53228-2168
Phone (414) 949-1453

Other providers in Greenfield, WI

All providers in Greenfield, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.