Provider Demographics
NPI:1760257182
Name:BECKMANN-LENNAN, AUSTIN C (LMT)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:C
Last Name:BECKMANN-LENNAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4047 W FIRETHORN ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-1003
Mailing Address - Country:US
Mailing Address - Phone:520-227-6797
Mailing Address - Fax:
Practice Address - Street 1:4047 W FIRETHORN ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-1003
Practice Address - Country:US
Practice Address - Phone:520-227-6797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-29109225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist