Provider Demographics
NPI:1205961562
Name:TEUSINK, MATTHEW HENRY (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:HENRY
Last Name:TEUSINK
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 1:13215 N VERDE RIVER DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-8308
Mailing Address - Country:US
Mailing Address - Phone:480-837-5988
Mailing Address - Fax:480-837-5991
Practice Address - Street 1:13215 N VERDE RIVER DR
Practice Address - Street 2:SUITE 4
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-8308
Practice Address - Country:US
Practice Address - Phone:480-837-5988
Practice Address - Fax:480-837-5991
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor