Healthcare Provider Details

I. General information

NPI: 1760662787
Provider Name (Legal Business Name): MATTHEW GERARD FINK D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5359 HIGHWAY N SUITE 103
SAINT CHARLES MO
63304-7792
US

IV. Provider business mailing address

5359 HIGHWAY N SUITE 103
SAINT CHARLES MO
63304-7792
US

V. Phone/Fax

Practice location:
  • Phone: 636-922-0777
  • Fax: 636-922-0833
Mailing address:
  • Phone: 636-922-0777
  • Fax: 636-922-0833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2004008721
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: