MEDICARE: DR. MATTHEW STEVEN ROBERTS DC.

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	111N00000X	Chiropractor	002017	CT

General Provider Information

NPI Number	:	1659742054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW STEVEN ROBERTS DC.

Provider Business Mailing Address
First Line	:	162 SOUTH ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-6505
Country	:	US
Telephone Number	:	860-585-9797
Fax Number	:	860-589-9002

Provider Business Practice Location Address
First Line	:	40 RUSS ST
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-1520
Country	:	US
Telephone Number	:	860-606-3913
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	06/02/2021

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