Provider Demographics
NPI:1659402469
Name:MATZ, LINDA M (DC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:MATZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 S RUSSELL ST STE 115
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8579
Mailing Address - Country:US
Mailing Address - Phone:406-203-5180
Mailing Address - Fax:406-203-5178
Practice Address - Street 1:3700 S RUSSELL ST STE 115
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8579
Practice Address - Country:US
Practice Address - Phone:406-203-5180
Practice Address - Fax:406-203-5178
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT40771OtherBLUE CROSS PROVIDER NUMBE