Individual
DR. MATTHEW CHARLES KIRKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2504 MONROE ST, LAPORTE, IN 46350
(219) 326-5100
(219) 326-0180
Mailing address
2504 MONROE ST, LAPORTE, IN 46350
(219) 326-5100
(219) 326-0180
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001779
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083782
ANTHEM
—
05
—
200168750
—
IN
05
—
200377030A
—
IN
Enumeration date
08/04/2006
Last updated
01/13/2011
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