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General NPI Number Information
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NPI Number | 1962542308
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Entity Type | Organization
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Legal Business Name | BECKI LENTZ PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9052 11 MILE RD
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City | MECOSTA
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State | MI
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Zip | 49332-9743
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Country | US
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Telephone | 231-972-8289
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Fax | 231-972-7981
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Provider Business Mailing Address
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Address Line | 9052 11 MILE RD
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City | MECOSTA
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State | MI
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Zip | 49332-9743
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Country | US
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Telephone | 231-972-8289
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Fax | 231-972-7981
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Authorized Official
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Title or Position | OWNER
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Name | BECKI JO LENTZ
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Credential | PT
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Telephone | 231-972-8289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5501006244
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License Number State | MI
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