MEDICARE: DANIEL JOSEPH BECKER DC

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
1	111N00000X	Chiropractor	3122	NC
2	111N00000X	Chiropractor	2539	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1407906290	OTHER	SC	PRACTICE NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083697338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL JOSEPH BECKER DC

Provider Business Mailing Address
First Line	:	PO BOX 912
Second Line	:
City	:	TRYON
State	:	NC
Zip	:	28782-0912
Country	:	US
Telephone Number	:	828-817-5524
Fax Number	:	866-518-5637

Provider Business Practice Location Address
First Line	:	104 PALMER ST
Second Line	:
City	:	TRYON
State	:	NC
Zip	:	28782-3433
Country	:	US
Telephone Number	:	828-817-5524
Fax Number	:	866-518-5637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	03/22/2011

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