Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 16037 | AR |
N | 111NN1001X | Nutrition | 16037 | AR |
N | 111NR0400X | Rehabilitation Chiropractor | 16037 | AR |
NPI | 1326476888 |
---|---|
Provider Name | Dr. Justin Beagley |
First Address | Bentonville, AR 72712-5771 |
Second Address | Bentonville, AR 72712-5771 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2013 |
Last Update Date | 31/01/2020 |