Healthcare Provider Details

I. General information

NPI: 1952220451
Provider Name (Legal Business Name): MATTHEW JOHN ZAKUTNEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 N FRIENDSHIP RD UNIT 3
PADUCAH KY
42001-9177
US

IV. Provider business mailing address

1545 GLENEAGLES DR
PADUCAH KY
42001-8657
US

V. Phone/Fax

Practice location:
  • Phone: 618-309-5517
  • Fax:
Mailing address:
  • Phone: 270-933-3355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number309862
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: