Provider Demographics
NPI:1770755324
Name:BEAU S. LAWYER, D.C., INC.
Entity type:Organization
Organization Name:BEAU S. LAWYER, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-486-6755
Mailing Address - Street 1:1400 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2901
Mailing Address - Country:US
Mailing Address - Phone:614-486-6755
Mailing Address - Fax:614-486-6781
Practice Address - Street 1:1400 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2901
Practice Address - Country:US
Practice Address - Phone:614-486-6755
Practice Address - Fax:614-486-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH44-00323OtherUHC PIN
OH44-00323OtherUHC PIN
OH0756192Medicare PIN