Provider Demographics
NPI:1275972218
Name:BECKHAM, DAVID RYAN (DPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RYAN
Last Name:BECKHAM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 VISION DR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-3855
Mailing Address - Country:US
Mailing Address - Phone:336-672-5450
Mailing Address - Fax:
Practice Address - Street 1:400 VISION DR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-3855
Practice Address - Country:US
Practice Address - Phone:336-672-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP10968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist