Provider Demographics
NPI:1265922132
Name:BECK, JOSHUA DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DEAN
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 1:17230 COUNTY ROAD 18
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-8681
Mailing Address - Country:US
Mailing Address - Phone:219-916-4456
Mailing Address - Fax:
Practice Address - Street 1:9921 COLDWATER RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-2041
Practice Address - Country:US
Practice Address - Phone:260-218-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002962A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor