Provider Demographics
NPI:1346000932
Name:MATIAS HEALTH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MATIAS HEALTH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO MATIAS HEALTH CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SOAMMY
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:MATIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC CHIROPRACTOR
Authorized Official - Phone:470-800-4041
Mailing Address - Street 1:255 NORCROSS ST STE B
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3865
Mailing Address - Country:US
Mailing Address - Phone:470-800-4041
Mailing Address - Fax:
Practice Address - Street 1:255 NORCROSS ST STE B
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3865
Practice Address - Country:US
Practice Address - Phone:470-800-4041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty