Terry Robert Beeck, LAT/ATC

Individual provider Active NPI Athletic Trainer · Green Bay, WI

NPI 1629066451 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1629066451
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
192-039 (WI)
Practice address
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone
(920) 430-4750
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

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
192-039WIMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 192-039 WI Yes

Addresses

Primary practice location

1630 Commanche Ave
Green Bay, WI 54313-5753

Mailing address

805 Jordan Rd
De Pere, WI 54115-3206
Phone (920) 339-5167

Other providers in Green Bay, WI

All providers in Green Bay, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.