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General NPI Number Information
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NPI Number | 1033436290
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Entity Type | Individual
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Provider Name | JOHN ANTHONY MATLOCK D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 291 PICKFORD AVENUE
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865
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Country | US
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Telephone | 908-859-0300
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Fax | 908-859-0315
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Provider Business Mailing Address
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Address Line | 291 PICKFORD AVE
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-1626
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Country | US
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Telephone | 908-859-0300
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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 | X011858
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00688100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC010334
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License Number State | PA
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