Provider Demographics
NPI:1285060871
Name:MATHEY, NICOLE (DC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:MATHEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 HUNTSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-7647
Mailing Address - Country:US
Mailing Address - Phone:931-227-4637
Mailing Address - Fax:
Practice Address - Street 1:2686 HUNTSVILLE HWY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-7647
Practice Address - Country:US
Practice Address - Phone:931-227-4637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2702111N00000X
CO4940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor