Provider Demographics
NPI:1871665802
Name:BEAULIEU, PIERRE A (DC)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:A
Last Name:BEAULIEU
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 1:5040 EAST SHEA BLVD #152
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:480-998-2117
Mailing Address - Fax:480-998-1519
Practice Address - Street 1:5040 EAST SHEA BLVD #152
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254
Practice Address - Country:US
Practice Address - Phone:480-998-2117
Practice Address - Fax:480-998-1519
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z1228OtherHEALTH NET
AZ0004315487OtherAETNA
AZ5140807OtherCIGNA
AZAZ0082410OtherBLUE CROSS BLUE SHIELD
AZAZ0082410OtherBLUE CROSS BLUE SHIELD