Provider Demographics
NPI:1003286949
Name:CONROY, MATTHEW CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:CHARLES
Last Name:CONROY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-6526
Mailing Address - Country:US
Mailing Address - Phone:484-515-5741
Mailing Address - Fax:
Practice Address - Street 1:1281 PA-113
Practice Address - Street 2:UNIT B
Practice Address - City:BLOOMING GLEN
Practice Address - State:PA
Practice Address - Zip Code:18911
Practice Address - Country:US
Practice Address - Phone:215-257-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011069111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111115Medicare UPIN