Provider Demographics
NPI:1316943988
Name:FRENCH, MATTHEW MICHAEL (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:FRENCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20045 N 19TH AVE
Mailing Address - Street 2:BLDG#11, STE#166
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4252
Mailing Address - Country:US
Mailing Address - Phone:602-866-8300
Mailing Address - Fax:623-234-9661
Practice Address - Street 1:20045 N 19TH AVE
Practice Address - Street 2:BLDG. #11, STE.#166
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4252
Practice Address - Country:US
Practice Address - Phone:602-866-8300
Practice Address - Fax:623-234-9661
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5841111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0248380OtherBLUE CROSS BLUE SHIELD
AZ350053211OtherRAILROAD MEDICARE
AZZ29269Medicare PIN
AZ0248380OtherBLUE CROSS BLUE SHIELD