Provider Demographics
NPI:1861480352
Name:MATZ, CONRAD FRANCIS III (DC)
Entity Type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:FRANCIS
Last Name:MATZ
Suffix:III
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 1:3825 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1842
Mailing Address - Country:US
Mailing Address - Phone:724-327-0922
Mailing Address - Fax:724-327-9655
Practice Address - Street 1:3825 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1842
Practice Address - Country:US
Practice Address - Phone:724-327-0922
Practice Address - Fax:724-327-9655
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001560L111N00000X
WV203111N00000X
GACHIR001148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000621980Medicaid
PA2096147OtherAETNA US HEALTHCARE
PA002012012001OtherUNITED HEALTH CARE
PA104009OtherUPMC
PA1018434OtherASHN
PA391886617OtherTRIAD
PA112260400OtherCIGNA
PA279511OtherBLUE CROSS BLUE SHIELD
PA2096147OtherAETNA US HEALTHCARE
PA000621980Medicaid