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General NPI Number Information
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NPI Number | 1477585537
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Entity Type | Individual
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Provider Name | MATTHEW OWEN ISNER DC
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 1510 ELIZABETH PIKE
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City | MINERAL WELLS
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State | WV
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Zip | 26150-8413
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Country | US
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Telephone | 386-852-0110
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 NATURE VIEW CIR
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City | PORT ORANGE
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State | FL
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Zip | 32128-7454
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Country | US
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Telephone | 386-788-2596
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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 | CHIRO08035
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 868
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License Number State | WV
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