Provider Demographics
NPI:1700897089
Name:BECKMANN, PATRICK MICHAEL (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:BECKMANN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CHAMPIONS DR
Mailing Address - Street 2:230 MIZZOU ARENA
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65211-0001
Mailing Address - Country:US
Mailing Address - Phone:573-882-3532
Mailing Address - Fax:573-884-0692
Practice Address - Street 1:1 CHAMPIONS DR
Practice Address - Street 2:230 MIZZOU ARENA
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65211-0001
Practice Address - Country:US
Practice Address - Phone:573-882-3532
Practice Address - Fax:573-884-0692
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1074962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer