Healthcare Provider Details

I. General information

NPI: 1073643508
Provider Name (Legal Business Name): BECKORD'S INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2922 WILDWOOD AVE
JACKSON MI
49202-3949
US

IV. Provider business mailing address

2922 WILDWOOD AVE
JACKSON MI
49202-3949
US

V. Phone/Fax

Practice location:
  • Phone: 517-782-5724
  • Fax: 517-782-2057
Mailing address:
  • Phone: 517-782-5724
  • Fax: 517-782-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501001375
License Number StateMI

VIII. Authorized Official

Name: MS. NIKI BECKORD
Title or Position: OWNER
Credential:
Phone: 517-782-5724