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General NPI Number Information
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NPI Number | 1619203932
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Entity Type | Organization
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Legal Business Name | MATTHEWS CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 10/21/2009
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Provider Practice Location Address
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Address Line | 1156 COLUMBUS AVE SUITE C
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-2612
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Country | US
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Telephone | 740-335-3008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-0035
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Country | US
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Telephone | 740-335-3008
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROMAN MATTHEWS
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Credential | D.C.
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Telephone | 740-335-3008
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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 | 3998
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License Number State | OH
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