Provider Demographics
NPI:1356531420
Name:UCHTMAN, MATTHEW ALAN (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALAN
Last Name:UCHTMAN
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 1:1812 CARONDALET DR
Mailing Address - Street 2:STE 102
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2284
Mailing Address - Country:US
Mailing Address - Phone:618-236-3600
Mailing Address - Fax:
Practice Address - Street 1:3030 FRANK SCOTT PKWY W
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-5014
Practice Address - Country:US
Practice Address - Phone:618-236-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor