MEDICARE: MATTES FAMILY & SPORTS CHIROPRACTIC PC

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
1	111NS0005X	Sports Physician Chiropractor	A06227	IA

General Provider Information

NPI Number	:	1518154301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTES FAMILY & SPORTS CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	119 1ST AVE W
Second Line	:
City	:	NEWTON
State	:	IA
Zip	:	50208-3721
Country	:	US
Telephone Number	:	641-787-0311
Fax Number	:	641-792-6396

Provider Business Practice Location Address
First Line	:	119 1ST AVE W
Second Line	:
City	:	NEWTON
State	:	IA
Zip	:	50208-3721
Country	:	US
Telephone Number	:	641-787-0311
Fax Number	:	641-792-6396

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. STEVEN JAMES MATTES
Credential	:	D.C.
Telephone Number	:	641-787-0311

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	07/09/2012

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