Provider Demographics
NPI:1114066826
Name:BEAM CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:BEAM CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:KATARINA
Authorized Official - Last Name:BON BEAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-901-3001
Mailing Address - Street 1:602 CANDLEWOOD CMNS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2173
Mailing Address - Country:US
Mailing Address - Phone:732-901-3001
Mailing Address - Fax:732-901-3105
Practice Address - Street 1:602 CANDLEWOOD CMNS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2173
Practice Address - Country:US
Practice Address - Phone:732-901-3001
Practice Address - Fax:732-901-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ455227OtherMEDICARE ID