Healthcare Provider Details

I. General information

NPI: 1639398340
Provider Name (Legal Business Name): HORVATH CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N WINSTEAD AVE
ROCKY MOUNT NC
27804-2235
US

IV. Provider business mailing address

112 VINEYARD CT
ROCKY MOUNT NC
27803-3104
US

V. Phone/Fax

Practice location:
  • Phone: 252-443-7496
  • Fax: 252-443-9062
Mailing address:
  • Phone: 252-977-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1182
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number006532
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1935
License Number StateNC

VIII. Authorized Official

Name: DR. MATTHEW BRIAN HORVATH
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 252-443-7496