MEDICARE: FULL CIRCLE CHIROPRACTIC INC

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	5232	KY

General Provider Information

NPI Number	:	1114242831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULL CIRCLE CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	12935 W HIGHWAY 42
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-9107
Country	:	US
Telephone Number	:	502-228-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	12935 W HIGHWAY 42
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-9107
Country	:	US
Telephone Number	:	502-228-5552
Fax Number	:	502-228-5542

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. ROBERT EDWARD MATTS
Credential	:	DC
Telephone Number	:	502-228-5552

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	09/15/2025

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