Provider Demographics
NPI:1235980400
Name:BECK, NORA ROSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:ROSE
Last Name:BECK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:ROSE
Other - Last Name:KEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9705 S BIRCHWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-3230
Mailing Address - Country:US
Mailing Address - Phone:608-658-3248
Mailing Address - Fax:
Practice Address - Street 1:100 N MARIO CAPECCHI DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1103
Practice Address - Country:US
Practice Address - Phone:608-658-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13810987-24012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics