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General NPI Number Information
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NPI Number | 1932103751
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Entity Type | Individual
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Provider Name | MATTHEW THOMAS GIANFORTE DC
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 22742 MIDLAND DR
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City | SHAWNEE
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State | KS
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Zip | 66226-3553
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Country | US
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Telephone | 913-441-2293
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Fax |
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Provider Business Mailing Address
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Address Line | 22742 MIDLAND DR
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City | SHAWNEE
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State | KS
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Zip | 66226-3553
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Country | US
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Telephone | 913-441-2293
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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 | 01-04961
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License Number State | KS
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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 | 2005006923
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License Number State | MO
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