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Individual

MR. HUMBERTO JOSE MATOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DAOM

Contact information

Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
DACM00104
RI
171100000X
Acupuncturist

Other

Enumeration date
06/11/2010
Last updated
06/01/2023
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