Provider Demographics
NPI:1568752947
Name:BECHTELL, JODIE MICHELLE (DSCPT)
Entity Type:Individual
Prefix:DR
First Name:JODIE
Middle Name:MICHELLE
Last Name:BECHTELL
Suffix:
Gender:F
Credentials:DSCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 MASON RD
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MI
Mailing Address - Zip Code:48097-1204
Mailing Address - Country:US
Mailing Address - Phone:810-387-2318
Mailing Address - Fax:
Practice Address - Street 1:615 PINE ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5400
Practice Address - Country:US
Practice Address - Phone:810-387-2318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist