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General NPI Number Information
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NPI Number | 1407140684
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Entity Type | Organization
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Legal Business Name | MATLOCK CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/05/2011
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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 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 | 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 | OWNER/CHIROPRACTOR
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Name | DR. JOHN ANTHONY MATLOK
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Credential | DC
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Telephone | 908-859-0300
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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 |
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License Number State |
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