Provider Demographics
NPI:1215368436
Name:BEADLE, JAMES DARREN (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DARREN
Last Name:BEADLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 E 1200 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6905
Mailing Address - Country:US
Mailing Address - Phone:801-900-3223
Mailing Address - Fax:
Practice Address - Street 1:251 E 1200 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6905
Practice Address - Country:US
Practice Address - Phone:801-900-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6561503-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor