Provider Demographics
NPI:1982681375
Name:MATTES, STEVEN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:MATTES
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 1:119 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3721
Mailing Address - Country:US
Mailing Address - Phone:641-787-0311
Mailing Address - Fax:641-792-6396
Practice Address - Street 1:119 1ST AVE W
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3721
Practice Address - Country:US
Practice Address - Phone:641-787-0311
Practice Address - Fax:641-792-6396
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO6227111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA49282OtherBLUE CROSS BLUE SHIELD PI
IA612396OtherUNITED HEALTHCARE PIN
IA1193185Medicaid
IA15031OtherMIDLANDS CHOICE PIN
IA15031OtherMIDLANDS CHOICE PIN