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General NPI Number Information
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NPI Number | 1306014493
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Entity Type | Organization
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Legal Business Name | MATLOCK CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 642 HILLIARD ST STE 1218
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City | MANCHESTER
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State | CT
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Zip | 06042-2702
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Country | US
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Telephone | 678-794-9334
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Fax |
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Provider Business Mailing Address
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Address Line | 642 HILLIARD ST STE 1218
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City | MANCHESTER
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State | CT
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Zip | 06042-2702
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Country | US
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Telephone | 678-794-9334
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Fax |
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Authorized Official
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Title or Position | PSD
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Name | DR. LUCAS MATLOCK
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Credential | DC
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Telephone | 561-746-8482
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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 | CH8884
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License Number State | FL
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