Provider Demographics
NPI:1386733434
Name:BEANLAND, REX H (DC)
Entity type:Individual
Prefix:DR
First Name:REX
Middle Name:H
Last Name:BEANLAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ELIZABETH PL NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1500
Mailing Address - Country:US
Mailing Address - Phone:330-493-1090
Mailing Address - Fax:
Practice Address - Street 1:316 S CHAPEL ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-1613
Practice Address - Country:US
Practice Address - Phone:330-875-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor