Provider Demographics
NPI:1447389341
Name:CHILDS, JOSEPH MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MATTHEW
Last Name:CHILDS
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 1:797 EAST LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335
Mailing Address - Country:US
Mailing Address - Phone:610-518-3370
Mailing Address - Fax:610-518-3371
Practice Address - Street 1:797 EAST LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335
Practice Address - Country:US
Practice Address - Phone:610-518-3370
Practice Address - Fax:610-518-3371
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007204L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
268709OtherNON BCBS INSURER