John Beck, COTA

Individual provider Active NPI Occupational Therapy Assistant · Franklin, WI

NPI 1871901488 · NPPES record last updated Jul 28, 2014

Key facts

NPI
1871901488
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057.003548 (IL)
Practice address
8420 W Drexel Ave
Franklin, WI 53132-9725
Phone
(414) 217-5831
NPI assigned
Jul 28, 2014
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
057.003548ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.003548 IL Yes

Addresses

Primary practice location

8420 W Drexel Ave
Franklin, WI 53132-9725

Mailing address

8420 W Drexel Ave
Franklin, WI 53132-9725
Phone (414) 217-5831

Other providers in Franklin, WI

All providers in Franklin, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.