Basic Information
| Provider Information | |||||||||
| NPI: | 1881351781 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECRAFT | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | AARON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 PENNSYLVANIA AVE | ||||||||
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| City: | CENTREVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216171136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4432626950 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15005 HEALTH CENTER DR | ||||||||
| Address2: | |||||||||
| City: | BOWIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207161017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018056070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2021 | ||||||||
| LastUpdateDate: | 11/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | A5267 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.