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General NPI Number Information
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NPI Number | 1154984516
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Entity Type | Individual
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Provider Name | MATTHEW TUTTLE DC
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Gender | Male
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Dates
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Enumeration Date | 04/20/2019
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 94-137 LEOLEO ST
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City | WAIPAHU
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State | HI
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Zip | 96797-2233
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Country | US
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Telephone | 808-779-0144
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Fax |
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Provider Business Mailing Address
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Address Line | 87-1114 OHEOHE ST
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City | WAIANAE
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State | HI
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Zip | 96792-3456
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Country | US
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Telephone | 808-779-0144
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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 | 1009
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License Number State | HI
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