Basic Information
Provider Information
NPI: 1295302289
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BECKMAN
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14287 N 87TH ST STE 220
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852603698
CountryCode: US
TelephoneNumber: 6023298250
FaxNumber: 4805651898
Practice Location
Address1: 3540 E BASELINE RD STE 103
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850429628
CountryCode: US
TelephoneNumber: 6022431476
FaxNumber: 6022431010
Other Information
ProviderEnumerationDate: 06/08/2021
LastUpdateDate: 02/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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