Healthcare Provider Details

I. General information

NPI: 1902877871
Provider Name (Legal Business Name): CONRAD FRANCIS MATZ IV DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 OLD WILLIAM PENN HWY
MURRYSVILLE PA
15668-1842
US

IV. Provider business mailing address

3825 OLD WILLIAM PENN HWY
MURRYSVILLE PA
15668-1842
US

V. Phone/Fax

Practice location:
  • Phone: 724-327-0922
  • Fax: 724-327-9655
Mailing address:
  • Phone: 724-327-0922
  • Fax: 724-327-9655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009545
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: