Provider Demographics
NPI:1366655649
Name:MATTHEWS CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:MATTHEWS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-777-4495
Mailing Address - Street 1:215 N KENHORST BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1535
Mailing Address - Country:US
Mailing Address - Phone:610-777-4495
Mailing Address - Fax:610-777-3709
Practice Address - Street 1:215 N KENHORST BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-1535
Practice Address - Country:US
Practice Address - Phone:610-777-4495
Practice Address - Fax:610-777-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003627L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA088610Medicare ID - Type UnspecifiedGROUP ID NUMBER