Healthcare Provider Details

I. General information

NPI: 1134896343
Provider Name (Legal Business Name): BEACHVIEW CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35202 ATLANTIC AVE
MILLVILLE DE
19967-6901
US

IV. Provider business mailing address

35202 ATLANTIC AVE
MILLVILLE DE
19967-6901
US

V. Phone/Fax

Practice location:
  • Phone: 302-539-7063
  • Fax: 302-539-8736
Mailing address:
  • Phone: 302-539-7063
  • Fax: 302-539-8736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KAREN M BAILEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-539-7063