Provider Demographics
NPI:1588792667
Name:BETTER HEALTH CHIROPRACTIC ET AL SCOTT BEAVERS GEN PTR
Entity type:Organization
Organization Name:BETTER HEALTH CHIROPRACTIC ET AL SCOTT BEAVERS GEN PTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABATE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-632-2676
Mailing Address - Street 1:4700 ROCKLIN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-3334
Mailing Address - Country:US
Mailing Address - Phone:916-632-2676
Mailing Address - Fax:916-632-9869
Practice Address - Street 1:4700 ROCKLIN RD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3334
Practice Address - Country:US
Practice Address - Phone:916-632-2676
Practice Address - Fax:916-632-9869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ53361ZOtherBLUE SHIELD
CAZZZ53361ZOtherBLUE SHIELD