Individual
MR. MATTHEW J CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
96 UNION ST, EASTHAMPTON, MA 01027-1450
(724) 882-7963
Mailing address
96 UNION ST, EASTHAMPTON, MA 01027-1450
(724) 882-7963
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
001688
CT
111N00000X
Chiropractor
Primary
3226
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001688CT01
ANTHEM BLUE CROSS
CT
01
—
11618170
CAQH
CT
Enumeration date
11/01/2006
Last updated
05/06/2009
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