Provider Demographics
NPI:1427603166
Name:MATRIX CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MATRIX CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SPOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-263-3008
Mailing Address - Street 1:107 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4017
Mailing Address - Country:US
Mailing Address - Phone:864-263-3008
Mailing Address - Fax:
Practice Address - Street 1:51 POINTE CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3505
Practice Address - Country:US
Practice Address - Phone:864-263-3008
Practice Address - Fax:864-263-3499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty