Provider Demographics
NPI:1770629479
Name:RAMIREZ, MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:RAMIREZ
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 1:141 E. 5600 S.
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-8240
Mailing Address - Country:US
Mailing Address - Phone:801-685-2862
Mailing Address - Fax:
Practice Address - Street 1:141 E. 5600 S.
Practice Address - Street 2:SUITE 309
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8240
Practice Address - Country:US
Practice Address - Phone:801-685-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3632311202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor