Provider Demographics
NPI:1023353927
Name:BECKLEY, DAWNICE KOREN (PT)
Entity type:Individual
Prefix:MISS
First Name:DAWNICE
Middle Name:KOREN
Last Name:BECKLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2613
Mailing Address - Country:US
Mailing Address - Phone:740-438-1323
Mailing Address - Fax:
Practice Address - Street 1:720 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2613
Practice Address - Country:US
Practice Address - Phone:740-438-1323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist