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General NPI Number Information
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NPI Number | 1558587295
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Entity Type | Organization
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Legal Business Name | BECKER OPTOMETRY PC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 222 MARKET DR
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City | PERHAM
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State | MN
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Zip | 56573-2116
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Country | US
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Telephone | 218-346-3073
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Fax | 218-346-3074
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Provider Business Mailing Address
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Address Line | 222 MARKET DR
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City | PERHAM
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State | MN
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Zip | 56573-2116
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Country | US
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Telephone | 218-346-3073
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Fax | 218-346-3074
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Authorized Official
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Title or Position | PRESIDENT
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Name | COREY BECKER
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Credential | O.D.
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Telephone | 218-230-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2951
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License Number State | MN
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