Provider Demographics
NPI:1326138017
Name:HOLTEN, MATTHEW A (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:HOLTEN
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 1:10524 CRAINS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-0840
Mailing Address - Country:US
Mailing Address - Phone:937-353-3080
Mailing Address - Fax:
Practice Address - Street 1:7626 PARAGON RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4049
Practice Address - Country:US
Practice Address - Phone:937-435-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHO0860651Medicare ID - Type UnspecifiedMEDICARE ID
OHU74251Medicare UPIN