Provider Demographics
NPI:1568789378
Name:MATTHEWS, BRIAN JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOHN
Last Name:MATTHEWS
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 1:5100 S DIXIE HWY
Mailing Address - Street 2:STE 9
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-3240
Mailing Address - Country:US
Mailing Address - Phone:561-547-7878
Mailing Address - Fax:561-547-7879
Practice Address - Street 1:5100 S DIXIE HWY
Practice Address - Street 2:STE 9
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-3240
Practice Address - Country:US
Practice Address - Phone:561-547-7878
Practice Address - Fax:561-547-7879
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor