Healthcare Provider Details

I. General information

NPI: 1295646552
Provider Name (Legal Business Name): MATTHEW HALL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 OVERLAND DR APT C203
LAWRENCE KS
66049-2167
US

IV. Provider business mailing address

4500 OVERLAND DR APT C203
LAWRENCE KS
66049-2167
US

V. Phone/Fax

Practice location:
  • Phone: 620-440-9473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number111N09999X
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: