Provider Demographics
NPI:1649332677
Name:BEYER, MARTIN CHARLES PEARCE (DC)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:CHARLES PEARCE
Last Name:BEYER
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 1:967 S SABINO DRIVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296
Mailing Address - Country:US
Mailing Address - Phone:480-544-0328
Mailing Address - Fax:785-272-5623
Practice Address - Street 1:3654 N POWER ROAD
Practice Address - Street 2:STE#143
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215
Practice Address - Country:US
Practice Address - Phone:480-396-8665
Practice Address - Fax:785-272-5623
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor