Provider Demographics
NPI:1326020439
Name:SPIERS, MATT LIBERTY (DC FAAIM)
Entity Type:Individual
Prefix:DR
First Name:MATT
Middle Name:LIBERTY
Last Name:SPIERS
Suffix:
Gender:M
Credentials:DC FAAIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12611 ECKEL JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1304
Mailing Address - Country:US
Mailing Address - Phone:419-873-6326
Mailing Address - Fax:419-873-6327
Practice Address - Street 1:12611 ECKEL JUNCTION RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1304
Practice Address - Country:US
Practice Address - Phone:419-873-6326
Practice Address - Fax:419-873-6327
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3476111N00000X
MI2301009459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1193641OtherCAQH
OH2470400Medicaid
OH582785Medicaid
9436014OtherCIGNA
7270516OtherAETNA
000000492224OtherANTHEM
MI95-0E80115-0OtherBCBSM
663535OtherACN/UNITED
OH2470400Medicaid
9436014OtherCIGNA
OH2470400Medicaid
000000492224OtherANTHEM