MEDICARE: DR. MATTHEW GARY HYOPPONEN 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	5099	MN

General Provider Information

NPI Number	:	1487811642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW GARY HYOPPONEN D.C.

Provider Business Mailing Address
First Line	:	2470 MCKNIGHT RD N
Second Line	:
City	:	NORTH ST PAUL
State	:	MN
Zip	:	55109-2236
Country	:	US
Telephone Number	:	651-777-3877
Fax Number	:	651-773-0708

Provider Business Practice Location Address
First Line	:	2470 MCKNIGHT RD N
Second Line	:
City	:	NORTH ST PAUL
State	:	MN
Zip	:	55109-2236
Country	:	US
Telephone Number	:	651-777-3877
Fax Number	:	651-773-0708

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

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/16/2008

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