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NPI Code Detail

MEDICARE: LYNN BEALS-BECKER, D.O., PLC

MEDICARE: LYNN BEALS-BECKER, D.O., PLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204D00000XNeuromusculoskeletal Medicine & OMM Physician5101012614MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11258111844OTHERMIBCBS MI

General Provider Information

NPI Number : 1003017310
Entity Type Code : Organization
Provider Name (Legal Business Name) : LYNN BEALS-BECKER, D.O., PLC
Provider Business Mailing Address
First Line : 6303 TODDS LN
Second Line :
City : DEXTER
State : MI
Zip : 48130-9668
Country : US
Telephone Number : 734-213-2996
Fax Number : 734-213-2997
Provider Business Practice Location Address
First Line : 5060 JACKSON RD STE C
Second Line :
City : ANN ARBOR
State : MI
Zip : 48103-1867
Country : US
Telephone Number : 734-213-2996
Fax Number : 734-213-2997
Authorized Official
Title or Position : OWNER
Name : LYNN ELIZABETH BEALS
Credential :
Telephone Number : 734-213-2996
Provider Enumeration Date : 05/31/2007
Last Update Date : 02/16/2026

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