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General NPI Number Information
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NPI Number | 1053594127
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Entity Type | Organization
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Legal Business Name | BEYLEA CHIROPRACTIC CENTRE
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 683 BAY AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-3407
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Country | US
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Telephone | 732-244-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 683 BAY AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-3407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | THOMAS GRAY
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Credential |
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Telephone | 732-244-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00254300
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License Number State | NJ
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