Provider Demographics
NPI:1164607008
Name:BECK, DANA MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:MARIE
Last Name:BECK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:DAUGHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:307 1/2 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59722-1076
Mailing Address - Country:US
Mailing Address - Phone:406-846-3448
Mailing Address - Fax:406-843-2298
Practice Address - Street 1:307 1/2 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-1076
Practice Address - Country:US
Practice Address - Phone:406-846-3448
Practice Address - Fax:406-846-2298
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist