Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 3450 | NC |
NPI | 1144303108 |
---|---|
Provider Name | Dr. Matthew James Hargreaves |
First Address | Charlotte, NC 28202-1345 |
Second Address | Charlotte, NC 28202-0200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 21/07/2008 |