Provider Demographics
NPI:1144024993
Name:BECKER, DOUGLAS ROBERT (DPT)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ROBERT
Last Name:BECKER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 PRICKETT RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-4022
Mailing Address - Country:US
Mailing Address - Phone:803-361-7144
Mailing Address - Fax:
Practice Address - Street 1:1812 POWDER SPRINGS RD SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4382
Practice Address - Country:US
Practice Address - Phone:678-528-1704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT017591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist