Provider Demographics
NPI:1619155272
Name:BECKER, ANDREW S (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:BECKER
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 1:1777 S BELLAIRE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4306
Mailing Address - Country:US
Mailing Address - Phone:303-996-0381
Mailing Address - Fax:303-282-6462
Practice Address - Street 1:1777 S BELLAIRE ST STE G125
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4306
Practice Address - Country:US
Practice Address - Phone:303-996-0381
Practice Address - Fax:303-282-6462
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC49083Medicare UPIN