MEDICARE: ROMAN ADAM MATTHEWS DC

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	RM009280	MI
2	111N00000X	Chiropractor	3998	OH

General Provider Information

NPI Number	:	1447389168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMAN ADAM MATTHEWS DC

Provider Business Mailing Address
First Line	:	1135 LEESBURG AVE
Second Line	:
City	:	WASHINGTON COURT HOUSE
State	:	OH
Zip	:	43160-1269
Country	:	US
Telephone Number	:	740-333-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 LEESBURG AVE
Second Line	:
City	:	WASHINGTON COURT HOUSE
State	:	OH
Zip	:	43160-1269
Country	:	US
Telephone Number	:	740-333-9000
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/31/2024

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