MEDICARE: DR. MATTHEW PHILIP CORNIES D.C., H.B.SC., B.S.

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	DC0000002061	TN

General Provider Information

NPI Number	:	1538287412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW PHILIP CORNIES D.C., H.B.SC., B.S.

Provider Business Mailing Address
First Line	:	8834 EATONWICK DR
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-4650
Country	:	US
Telephone Number	:	901-937-9397
Fax Number	:

Provider Business Practice Location Address
First Line	:	3189 KIRBY WHITTEN RD
Second Line	:	SUITE 104
City	:	BARTLETT
State	:	TN
Zip	:	38134-2854
Country	:	US
Telephone Number	:	901-922-5398
Fax Number	:	901-922-5538

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	04/14/2011

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