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General NPI Number Information
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NPI Number | 1376864850
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Entity Type | Individual
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Provider Name | JOSHUA BEAUDRY D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 7200 E DRY CREEK RD SUITE G101
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City | CENTENNIAL
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State | CO
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Zip | 80112-2537
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Country | US
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Telephone | 303-770-0605
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 S COLORADO BLVD # C303
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City | DENVER
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State | CO
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Zip | 80222-3305
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Country | US
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Telephone | 303-770-0605
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2301009656
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6657
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License Number State | CO
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