Individual
MR. RANDALL RAYMOND BEACH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
300 W 23RD ST, BEACH CHIROPRACTIC ARTS CENTER, FREMONT, NE 68025-2547
(402) 721-1190
(402) 721-1199
Mailing address
300 W 23RD ST, FREMONT, NE 68025-2547
(402) 721-1190
(402) 721-1199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
690
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09811
BLUE CROSS BLUE SHIELD
NE
05
—
47075074900
—
NE
Enumeration date
11/23/2005
Last updated
07/09/2007
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