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NPI 1043534977

NPI 1043534977 : ROBERT EDWARD MATTS D.C. : PROSPECT, KY

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General NPI Number Information
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    NPI Number           |    1043534977
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT EDWARD MATTS D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/22/2010
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    Last Update Date     |    09/15/2025
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Provider Practice Location Address
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    Address Line         |    12935 W HIGHWAY 42 
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    City                 |    PROSPECT
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    State                |    KY
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    Zip                  |    40059-9107
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    Country              |    US
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    Telephone            |    502-228-5552
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    Fax                  |    502-228-5542
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Provider Business Mailing Address
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    Address Line         |    12935 W HIGHWAY 42 
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    City                 |    PROSPECT
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    State                |    KY
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    Zip                  |    40059-9107
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    Country              |    US
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    Telephone            |    502-228-5552
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    Fax                  |    502-228-5542
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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       |    5232
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    License Number State |    KY
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