Provider Demographics
NPI:1801932538
Name:CHAMBERS, MITCHELL S (DC)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:CHAMBERS
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 1:19 ZEPHYR DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4939
Mailing Address - Country:US
Mailing Address - Phone:413-572-4770
Mailing Address - Fax:
Practice Address - Street 1:1176 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3958
Practice Address - Country:US
Practice Address - Phone:413-593-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36070Medicare ID - Type Unspecified