Healthcare Provider Details

I. General information

NPI: 1457589624
Provider Name (Legal Business Name): MATTHEW NIXON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13240 N CLEVELAND AVE SUITE 9
NORTH FORT MYERS FL
33903-4855
US

IV. Provider business mailing address

13240 N CLEVELAND AVE SUITE 9
NORTH FORT MYERS FL
33903-4855
US

V. Phone/Fax

Practice location:
  • Phone: 239-656-3400
  • Fax: 239-656-3401
Mailing address:
  • Phone: 239-656-3400
  • Fax: 239-656-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW BRYAN NIXON
Title or Position: OWNER
Credential: D.C.
Phone: 239-656-3400