Provider Demographics
NPI:1952058323
Name:BEACH LIFE CHIROPRACTIC
Entity Type:Organization
Organization Name:BEACH LIFE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BELOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-943-8511
Mailing Address - Street 1:1115A N MCKENZIE ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-3550
Mailing Address - Country:US
Mailing Address - Phone:251-943-8511
Mailing Address - Fax:
Practice Address - Street 1:1115A N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3550
Practice Address - Country:US
Practice Address - Phone:251-943-8511
Practice Address - Fax:251-943-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty