Provider Demographics
NPI:1508965294
Name:HUEY, MATTHEW ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ALLEN
Last Name:HUEY
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 1:7816 UPLANDS WAY
Mailing Address - Street 2:STE. A
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7568
Mailing Address - Country:US
Mailing Address - Phone:916-967-5088
Mailing Address - Fax:916-967-5089
Practice Address - Street 1:7816 UPLANDS WAY
Practice Address - Street 2:STE. A
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7568
Practice Address - Country:US
Practice Address - Phone:916-967-5088
Practice Address - Fax:916-967-5089
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV05108Medicare UPIN