KENNETH BECKER

MOUNTAIN HOME AFB, ID
NPI1598185233
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ID  AT-394)
Enumeration Date2014-04-21
Last Update Date2021-08-23
Business Address
MR. KENNETH BECKER ATC
366 GUNFIGHTER AVE STE 498
MOUNTAIN HOME AFB, ID 83648-5258
Phone number: 208-724-4782
Mailing Address
MR. KENNETH BECKER ATC
133 MAGNOLIA AVE SE
FORT WALTON BEACH, FL 32548-7266
Phone number: