Provider Demographics
NPI:1457542904
Name:HULL, MATTHEW BRYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BRYAN
Last Name:HULL
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 1:1424 LEGEND HILLS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1596
Mailing Address - Country:US
Mailing Address - Phone:801-774-6602
Mailing Address - Fax:801-614-1210
Practice Address - Street 1:1424 LEGEND HILLS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1596
Practice Address - Country:US
Practice Address - Phone:801-774-6602
Practice Address - Fax:801-614-1210
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6688518-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor