MEDICARE: MR. GERRY JOSEPH BECKER L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist	33.009947 A-B	OH

General Provider Information

NPI Number	:	1578869186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GERRY JOSEPH BECKER L.M.T.

Provider Business Mailing Address
First Line	:	1845 HANFIELD ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45223-1962
Country	:	US
Telephone Number	:	513-591-2942
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 HANFIELD ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45223-1962
Country	:	US
Telephone Number	:	513-591-2942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2011
Last Update Date	:	01/28/2011

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Directions to “ MR. GERRY JOSEPH BECKER L.M.T.” Practice Location

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