Provider Demographics
NPI:1477629566
Name:BECK, STEVEN ROBERT (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROBERT
Last Name:BECK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 TERREY PINE COURT
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1126
Mailing Address - Country:US
Mailing Address - Phone:952-937-1226
Mailing Address - Fax:952-906-1811
Practice Address - Street 1:7810 TERREY PINE COURT
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1126
Practice Address - Country:US
Practice Address - Phone:952-937-1226
Practice Address - Fax:952-906-1811
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN1230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
230072OtherACN
65Q60BEOtherBLUE CROSS
65Q60BEOtherBLUE CROSS