Provider Demographics
NPI:1790036374
Name:BECKERS, DENISE L (PTA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:BECKERS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 MADISON AVE
Mailing Address - Street 2:#114
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3406
Mailing Address - Country:US
Mailing Address - Phone:417-425-4450
Mailing Address - Fax:
Practice Address - Street 1:6400 GLENWOOD ST
Practice Address - Street 2:SUITE 111
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4028
Practice Address - Country:US
Practice Address - Phone:913-831-2721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011021955225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant