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NPI Code Detail

MEDICARE: BRUCE S BEAULIEU DC

MEDICARE: BRUCE S BEAULIEU DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH7902FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164428181
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE S BEAULIEU DC
Provider Business Mailing Address
First Line : 910 NE 2ND ST
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-2138
Country : US
Telephone Number : 954-570-7699
Fax Number : 954-570-7698
Provider Business Practice Location Address
First Line : 910 NE 2ND ST
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-2138
Country : US
Telephone Number : 954-570-7699
Fax Number : 954-570-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 05/08/2008

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Directions to “ BRUCE S BEAULIEU DC” Practice Location

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