Provider Demographics
NPI:1710370127
Name:MORGAN, MATTHEW JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOHN
Last Name:MORGAN
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 1:16 LUZERNE AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-2800
Mailing Address - Country:US
Mailing Address - Phone:570-569-2582
Mailing Address - Fax:570-569-2584
Practice Address - Street 1:16 LUZERNE AVE STE 160
Practice Address - Street 2:
Practice Address - City:WEST PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18643-2800
Practice Address - Country:US
Practice Address - Phone:570-569-2582
Practice Address - Fax:570-569-2584
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor