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Individual

DR. MATTHEW PALM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
18209 EULA MAE PKWY, CARLYLE, IL 62231-6407
(618) 594-3671
Mailing address
PO BOX 94, HOFFMAN, IL 62250-0094
(618) 218-3787

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-012517
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
038-012517
ILLINOIS LICENSE
IL
Enumeration date
10/25/2013
Last updated
10/25/2013
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