Provider Demographics
NPI:1922243799
Name:MATTHEW HOTZ CHIROPRACTOR PLLC
Entity Type:Organization
Organization Name:MATTHEW HOTZ CHIROPRACTOR PLLC
Other - Org Name:DR MATTHEW HOTZ CHIROPRACTOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-642-4300
Mailing Address - Street 1:43 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03848-3011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43 CHURCH ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848-3011
Practice Address - Country:US
Practice Address - Phone:603-642-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2450495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80004157Medicaid
U64789Medicare UPIN
NH80004157Medicaid