Provider Demographics
NPI:1659700185
Name:MATTHEW A. MIHAJLOVITS DC PLLC
Entity Type:Organization
Organization Name:MATTHEW A. MIHAJLOVITS DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIHAJLOVITS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-361-1159
Mailing Address - Street 1:PO BOX 21475
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40221-0475
Mailing Address - Country:US
Mailing Address - Phone:502-361-1159
Mailing Address - Fax:502-361-0421
Practice Address - Street 1:4602 SOUTHERN PKWY
Practice Address - Street 2:STE 1A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1429
Practice Address - Country:US
Practice Address - Phone:502-361-1159
Practice Address - Fax:502-361-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty