Provider Demographics
NPI:1154984516
Name:TUTTLE, MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87-1114 OHEOHE ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3456
Mailing Address - Country:US
Mailing Address - Phone:808-779-0144
Mailing Address - Fax:
Practice Address - Street 1:94-137 LEOLEO ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2233
Practice Address - Country:US
Practice Address - Phone:808-779-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-20
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor