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General NPI Number Information
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NPI Number | 1063388130
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Entity Type | Individual
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Provider Name | MATTHEW ALEXANDER WALTER D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 2201 1ST CAPITOL DR
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City | SAINT CHARLES
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State | MO
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Zip | 63301-5805
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Country | US
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Telephone | 636-916-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 7106 CASTLE CLIFF CT
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City | SAINT CHARLES
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State | MO
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Zip | 63304-7498
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Country | US
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Telephone |
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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 | 2025036267
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License Number State | MO
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