Provider Demographics
NPI:1356414585
Name:BEAUGEZ, CALVIN M JR (DC)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:M
Last Name:BEAUGEZ
Suffix:JR
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 1:495 E 4500 S
Mailing Address - Street 2:SUITE #105
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2766
Mailing Address - Country:US
Mailing Address - Phone:801-281-1111
Mailing Address - Fax:801-281-2026
Practice Address - Street 1:495 E 4500 S
Practice Address - Street 2:SUITE #105
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2766
Practice Address - Country:US
Practice Address - Phone:801-281-1111
Practice Address - Fax:801-281-2026
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT334984-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor