Provider Demographics
NPI:1043388747
Name:MORGANTOWN CHIROPRACTIC & DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:MORGANTOWN CHIROPRACTIC & DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-777-4495
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:MORGANTOWN CHIROPRACTIC & DIAGNOSTIC CENTER
Mailing Address - City:MORGANTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19543-0663
Mailing Address - Country:US
Mailing Address - Phone:610-286-6626
Mailing Address - Fax:610-286-9273
Practice Address - Street 1:150 MOREVIEW BLVD
Practice Address - Street 2:2ND FLOOR MARTINS MARKET
Practice Address - City:MORGANTOWN
Practice Address - State:PA
Practice Address - Zip Code:19543-9100
Practice Address - Country:US
Practice Address - Phone:610-286-6626
Practice Address - Fax:610-286-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty