Provider Demographics
NPI:1154929164
Name:DR. CALVIN'S CLINIC OF OGDEN
Entity type:Organization
Organization Name:DR. CALVIN'S CLINIC OF OGDEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DR CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUGEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-598-5057
Mailing Address - Street 1:2351 GRANT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-1437
Mailing Address - Country:US
Mailing Address - Phone:801-598-5057
Mailing Address - Fax:
Practice Address - Street 1:2351 GRANT AVE STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-1437
Practice Address - Country:US
Practice Address - Phone:801-598-5057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty