Provider Demographics
NPI:1366677023
Name:MATHEWS, DAN ROBBINS JR (DC)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:ROBBINS
Last Name:MATHEWS
Suffix:JR
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 1:144 S INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4620
Mailing Address - Country:US
Mailing Address - Phone:662-840-7600
Mailing Address - Fax:
Practice Address - Street 1:144 S INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4620
Practice Address - Country:US
Practice Address - Phone:662-840-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS111N00000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor