Healthcare Provider Details

I. General information

NPI: 1861872350
Provider Name (Legal Business Name): BEABB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E LANCASTER AVENUE SUITE 304
ARDMORE PA
19003
US

IV. Provider business mailing address

BEABB INC 600 LOUIS DRIVE SUITE 202
WARMINSTER PA
18974
US

V. Phone/Fax

Practice location:
  • Phone: 215-486-1800
  • Fax: 215-657-9398
Mailing address:
  • Phone: 215-957-5400
  • Fax: 215-957-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRIAN M BAYZICK
Title or Position: COO
Credential:
Phone: 215-957-5400