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General NPI Number Information
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NPI Number | 1992873236
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Entity Type | Organization
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Legal Business Name | BEAUMONT FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 1305 E MILLBROOK RD STE C101
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City | RALEIGH
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State | NC
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Zip | 27609-5400
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Country | US
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Telephone | 919-871-0349
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Fax | 919-871-0359
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Provider Business Mailing Address
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Address Line | 1305 E MILLBROOK RD STE C101
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City | RALEIGH
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State | NC
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Zip | 27609-5400
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Country | US
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Telephone | 919-871-0349
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Fax | 919-871-0359
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Authorized Official
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Title or Position | DOCTOR PRESIDENT
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Name | DR. MARION EARL BEAUMONT II
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Credential | DC
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Telephone | 919-891-0349
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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 | 3193
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License Number State | NC
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