Provider Demographics
NPI:1033192364
Name:BEALER, JENNIFER JUSTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JUSTINE
Last Name:BEALER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7842 BOYERTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-8109
Mailing Address - Country:US
Mailing Address - Phone:610-689-3700
Mailing Address - Fax:610-689-4467
Practice Address - Street 1:7842 BOYERTOWN PIKE
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-8109
Practice Address - Country:US
Practice Address - Phone:610-689-3700
Practice Address - Fax:610-689-4467
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1064067OtherAMERICAN SPECIALTY HEALTH
PA2620475000OtherPERSONAL CHOICE
PA7097799OtherAETNA PPO GROUP #
PA50057698OtherCAPITAL BC PROVIDER ID
PA7694759OtherAETNA PPO PROVIDER #
PABE1783140OtherHIGHMARK
PA076809UWAOtherMEDICARE PROVIDER #
PA50057700OtherCAPITAL BC GROUP ID
PA076809RXFOtherMEDICARE PROVIDER #
PA1107802OtherAETNA HMO #
PA50057698OtherCAPITAL BC PROVIDER ID
PAU98773Medicare UPIN