Provider Demographics
NPI:1164498119
Name:RODDA, BECKY JEAN (PT, MHS, OCS)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:JEAN
Last Name:RODDA
Suffix:
Gender:F
Credentials:PT, MHS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 COBBLERS DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-7829
Mailing Address - Country:US
Mailing Address - Phone:517-333-3194
Mailing Address - Fax:
Practice Address - Street 1:3544 MERIDIAN CROSSINGS
Practice Address - Street 2:SUITE 160
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6025
Practice Address - Country:US
Practice Address - Phone:517-347-2495
Practice Address - Fax:517-347-3540
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010022662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic