Healthcare Provider Details

I. General information

NPI: 1003017310
Provider Name (Legal Business Name): LYNN BEALS-BECKER, D.O., PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5060 JACKSON RD STE C
ANN ARBOR MI
48103-1867
US

IV. Provider business mailing address

6303 TODDS LN
DEXTER MI
48130-9668
US

V. Phone/Fax

Practice location:
  • Phone: 734-213-2996
  • Fax: 734-213-2997
Mailing address:
  • Phone: 734-213-2996
  • Fax: 734-213-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number5101012614
License Number StateMI

VIII. Authorized Official

Name: LYNN ELIZABETH BEALS
Title or Position: MEMBER
Credential: DO
Phone: 734-213-2996