Healthcare Provider Details

I. General information

NPI: 1093836371
Provider Name (Legal Business Name): MATTHEW J BEACHY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 MILL RD
BELLVILLE OH
44813-1280
US

IV. Provider business mailing address

751 MILL ROAD
BELLVILLE OH
44813-1280
US

V. Phone/Fax

Practice location:
  • Phone: 419-886-7007
  • Fax: 419-886-2080
Mailing address:
  • Phone: 419-886-7007
  • Fax: 419-886-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3481
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: