Provider Demographics
NPI:1346798782
Name:BECK, JOSEPH BRANDON (PT, DPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:BRANDON
Last Name:BECK
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 STILLWATER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005
Mailing Address - Country:US
Mailing Address - Phone:478-293-1680
Mailing Address - Fax:478-293-1685
Practice Address - Street 1:101 STILLWATER CIRCLE
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005
Practice Address - Country:US
Practice Address - Phone:478-293-1680
Practice Address - Fax:478-293-1685
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0030422255A2300X
GAPT014676225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer