MEDICARE: MATTHEW G HOOPER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC29064	CA
2	111N00000X	Chiropractor	8171	AZ

General Provider Information

NPI Number	:	1053358085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW G HOOPER D.C.

Provider Business Mailing Address
First Line	:	4350 E RAY RD STE 110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-4704
Country	:	US
Telephone Number	:	480-652-1234
Fax Number	:	480-361-7719

Provider Business Practice Location Address
First Line	:	4350 E RAY RD STE 110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-4704
Country	:	US
Telephone Number	:	480-652-1234
Fax Number	:	480-361-7719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	05/23/2023

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