Healthcare Provider Details

I. General information

NPI: 1992882591
Provider Name (Legal Business Name): MATHEW ZANE HILL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 MEMORIAL BLVD.
MARTINSVILLE VA
24112
US

IV. Provider business mailing address

1141 MEMORIAL BLVD.
MARTINSVILLE VA
24112
US

V. Phone/Fax

Practice location:
  • Phone: 276-632-3334
  • Fax: 276-632-1882
Mailing address:
  • Phone: 276-632-3334
  • Fax: 276-632-1882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104001311
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: