Healthcare Provider Details

I. General information

NPI: 1801275466
Provider Name (Legal Business Name): HARLEY GRANT BECK ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 CAMPUS DRIVE
GARDEN CITY KS
67846
US

IV. Provider business mailing address

1209 N 9TH ST
GARDEN CITY KS
67846-4219
US

V. Phone/Fax

Practice location:
  • Phone: 620-276-9617
  • Fax:
Mailing address:
  • Phone: 719-349-9902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number24-01572
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: