Provider Demographics
NPI:1861789596
Name:BECKER, AMBER NICHOL (DPT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICHOL
Last Name:BECKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:SAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 W HEFNER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5060
Mailing Address - Country:US
Mailing Address - Phone:405-751-9955
Mailing Address - Fax:405-751-9988
Practice Address - Street 1:3333 W HEFNER RD
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5060
Practice Address - Country:US
Practice Address - Phone:405-751-9955
Practice Address - Fax:405-751-9988
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT4464225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist