Provider Demographics
NPI:1699093252
Name:BEAUMONT FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BEAUMONT FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-752-1156
Mailing Address - Street 1:760 WOODBOURNE RD
Mailing Address - Street 2:AA
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1370
Mailing Address - Country:US
Mailing Address - Phone:215-752-1156
Mailing Address - Fax:215-752-1156
Practice Address - Street 1:760 WOODBOURNE RD
Practice Address - Street 2:AA
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1370
Practice Address - Country:US
Practice Address - Phone:215-752-1156
Practice Address - Fax:215-752-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-001678L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty