Provider Demographics
NPI:1164962783
Name:LAMPE, MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:LAMPE
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 1:328 ALEXANDER ST SE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2092
Mailing Address - Country:US
Mailing Address - Phone:678-750-3570
Mailing Address - Fax:
Practice Address - Street 1:328 ALEXANDER ST SE
Practice Address - Street 2:SUITE 12
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2092
Practice Address - Country:US
Practice Address - Phone:678-750-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor