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NPI Code Detail

MEDICARE: DR. MATTHEW JAMES PALLADINO D.C.

MEDICARE:  DR. MATTHEW JAMES PALLADINO  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor08002685AIN

General Provider Information

NPI Number : 1407123060
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW JAMES PALLADINO D.C.
Provider Business Mailing Address
First Line : 108 APPLE CT
Second Line :
City : WINONA LAKE
State : IN
Zip : 46590-1703
Country : US
Telephone Number : 402-297-7900
Fax Number :
Provider Business Practice Location Address
First Line : 408 W MAIN ST
Second Line :
City : NORTH MANCHESTER
State : IN
Zip : 46962-1508
Country : US
Telephone Number : 402-297-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2011
Last Update Date : 07/03/2020

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Directions to “ DR. MATTHEW JAMES PALLADINO D.C.” Practice Location

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