Provider Demographics
NPI:1871506220
Name:BECKLEY, MATTHEW J (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:BECKLEY
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 1:43B BIRCH ST
Mailing Address - Street 2:SUITE 3G
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2718
Mailing Address - Country:US
Mailing Address - Phone:603-537-9988
Mailing Address - Fax:603-537-9978
Practice Address - Street 1:43B BIRCH ST
Practice Address - Street 2:SUITE 3G
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2718
Practice Address - Country:US
Practice Address - Phone:603-537-9988
Practice Address - Fax:603-537-9978
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH721-05054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHBE-RE7913Medicare ID - Type Unspecified
NHU93927Medicare UPIN