MEDICARE: DR. CALVIN M BEAUGEZ JR. D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	334984-1202	UT

General Provider Information

NPI Number	:	1356414585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CALVIN M BEAUGEZ JR. D.C.

Provider Business Mailing Address
First Line	:	495 E 4500 S
Second Line	:	SUITE #105
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2766
Country	:	US
Telephone Number	:	801-281-1111
Fax Number	:	801-281-2026

Provider Business Practice Location Address
First Line	:	495 E 4500 S
Second Line	:	SUITE #105
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2766
Country	:	US
Telephone Number	:	801-281-1111
Fax Number	:	801-281-2026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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