Provider Demographics
NPI:1386899540
Name:HASTY, MATTHEW ERNEST (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ERNEST
Last Name:HASTY
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 1:563 BIELENBERG DR
Mailing Address - Street 2:SUITE 145
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4425
Mailing Address - Country:US
Mailing Address - Phone:651-731-4464
Mailing Address - Fax:651-379-5113
Practice Address - Street 1:563 BIELENBERG DR
Practice Address - Street 2:SUITE 145
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4425
Practice Address - Country:US
Practice Address - Phone:651-731-4464
Practice Address - Fax:651-379-5113
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC5152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor