Provider Demographics
NPI:1225702301
Name:HARRIS, MATTHEW PATTON (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PATTON
Last Name:HARRIS
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 1:7900 EXCELSIOR BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3423
Mailing Address - Country:US
Mailing Address - Phone:952-658-8995
Mailing Address - Fax:952-777-2263
Practice Address - Street 1:7900 EXCELSIOR BLVD
Practice Address - Street 2:STE 200
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3423
Practice Address - Country:US
Practice Address - Phone:952-658-8995
Practice Address - Fax:952-777-2263
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor