Provider Demographics
NPI:1275787376
Name:MATTHEW J ALVORD DC LTD
Entity Type:Organization
Organization Name:MATTHEW J ALVORD DC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ALVORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-944-2133
Mailing Address - Street 1:8781 COLUMBINE RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-6695
Mailing Address - Country:US
Mailing Address - Phone:952-944-2133
Mailing Address - Fax:952-914-7335
Practice Address - Street 1:8781 COLUMBINE RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-6695
Practice Address - Country:US
Practice Address - Phone:952-944-2133
Practice Address - Fax:952-914-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN98354600 MNMedicaid
MN1063410363OtherINDIVIDUAL NPI
MN1063410363OtherINDIVIDUAL NPI
MNU74356Medicare UPIN