Provider Demographics
NPI:1396869954
Name:BECKSTRAND, AMY M (MT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:BECKSTRAND
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18240 LEONARD RD
Mailing Address - Street 2:
Mailing Address - City:CLEARBROOK
Mailing Address - State:MN
Mailing Address - Zip Code:56634-4207
Mailing Address - Country:US
Mailing Address - Phone:218-776-3088
Mailing Address - Fax:
Practice Address - Street 1:18240 LEONARD RD
Practice Address - Street 2:
Practice Address - City:CLEARBROOK
Practice Address - State:MN
Practice Address - Zip Code:56634-4207
Practice Address - Country:US
Practice Address - Phone:218-776-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist