Provider Demographics
NPI:1124515697
Name:MATTHEWS CHIROPRACTIC AND REHABILITATION
Entity type:Organization
Organization Name:MATTHEWS CHIROPRACTIC AND REHABILITATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:724-961-0678
Mailing Address - Street 1:114 N AVON AVE
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8475
Mailing Address - Country:US
Mailing Address - Phone:317-272-4578
Mailing Address - Fax:
Practice Address - Street 1:7030 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7779
Practice Address - Country:US
Practice Address - Phone:317-272-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty