Healthcare Provider Details

I. General information

NPI: 1508601451
Provider Name (Legal Business Name): MATTHEW MYERS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 DUNN DR STE 123
STAFFORD VA
22556-1503
US

IV. Provider business mailing address

95 DUNN DR STE 123
STAFFORD VA
22556-1503
US

V. Phone/Fax

Practice location:
  • Phone: 703-523-9565
  • Fax: 833-627-5148
Mailing address:
  • Phone: 703-523-9565
  • Fax: 833-627-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104558114
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2024025434
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: