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General NPI Number Information
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NPI Number | 1669882296
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Entity Type | Individual
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Provider Name | LAURA TEETER BECK
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 155 ALLISON PAGE RD STE B
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City | ABERDEEN
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State | NC
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Zip | 28315-8956
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Country | US
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Telephone | 910-235-0655
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SPRING LAKE DR
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City | PINEHURST
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State | NC
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Zip | 28374-7099
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Country | US
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Telephone | 607-279-5862
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Fax | 910-475-1221
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | NU000011
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14812
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License Number State | NC
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