MEDICARE: DR. JOHN GEORGE BEATTY 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
1	111N00000X	Chiropractor	2301004081	MI

General Provider Information

NPI Number	:	1740307164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN GEORGE BEATTY DC

Provider Business Mailing Address
First Line	:	8050 GRAND RIVER RD
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48114-9341
Country	:	US
Telephone Number	:	810-227-1899
Fax Number	:	810-227-1910

Provider Business Practice Location Address
First Line	:	8050 GRAND RIVER RD
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48114-9341
Country	:	US
Telephone Number	:	810-227-1899
Fax Number	:	810-227-1910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	12/05/2007

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