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General NPI Number Information
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NPI Number | 1124214929
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Entity Type | Organization
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Legal Business Name | BEAM CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 09/15/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 2147 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1507
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Country | US
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Telephone | 719-638-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 2147 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1507
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Country | US
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Telephone | 719-638-8007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CYNTHIA M BEAM
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Credential | D.C.
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Telephone | 719-638-8007
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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 | CHR-5786
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License Number State | CO
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