Provider Demographics
NPI:1306957402
Name:IRWIN, MATTHEW JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAMES
Last Name:IRWIN
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 1:600 OAK ST
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3528
Mailing Address - Country:US
Mailing Address - Phone:724-863-3226
Mailing Address - Fax:724-864-9871
Practice Address - Street 1:600 OAK ST
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3528
Practice Address - Country:US
Practice Address - Phone:724-863-3226
Practice Address - Fax:724-864-9871
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004460L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU17542Medicare UPIN
PA64910Medicare ID - Type Unspecified