Provider Demographics
NPI:1962012732
Name:LINDA MATZ, P.C.
Entity Type:Organization
Organization Name:LINDA MATZ, P.C.
Other - Org Name:BLOOM CHIROPRACTIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-203-5180
Mailing Address - Street 1:3700 S RUSSELL ST STE 115
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8579
Mailing Address - Country:US
Mailing Address - Phone:406-203-5180
Mailing Address - Fax:406-830-3447
Practice Address - Street 1:3700 S RUSSELL ST STE 115
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8579
Practice Address - Country:US
Practice Address - Phone:406-203-5180
Practice Address - Fax:406-203-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty