Provider Demographics
NPI:1376864850
Name:BEAUDRY, JOSHUA (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:BEAUDRY
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 1:1355 S COLORADO BLVD
Mailing Address - Street 2:# C303
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3305
Mailing Address - Country:US
Mailing Address - Phone:303-770-0605
Mailing Address - Fax:
Practice Address - Street 1:7200 E DRY CREEK RD
Practice Address - Street 2:SUITE G101
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2537
Practice Address - Country:US
Practice Address - Phone:303-770-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009656111N00000X
CO6657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor