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General NPI Number Information
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NPI Number | 1013486224
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Entity Type | Individual
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Provider Name | MATTHAN WHEELER DC
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Gender | Male
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Dates
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Enumeration Date | 11/16/2018
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 3904 E MULLAN AVE STE C
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City | POST FALLS
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State | ID
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Zip | 83854-4009
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Country | US
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Telephone | 208-981-0093
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Fax | 208-981-0125
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Provider Business Mailing Address
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Address Line | 3904 E MULLAN AVE STE C
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City | POST FALLS
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State | ID
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Zip | 83854-4009
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Country | US
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Telephone | 208-981-0093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1900
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License Number State | ID
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