Provider Demographics
NPI:1457996183
Name:MATTHEWS, CHRISTOPHER (BS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HUBBARD FORK RD
Mailing Address - Street 2:
Mailing Address - City:FOSTER
Mailing Address - State:WV
Mailing Address - Zip Code:25081-9761
Mailing Address - Country:US
Mailing Address - Phone:304-400-5835
Mailing Address - Fax:
Practice Address - Street 1:2216 GUTHRIE CT
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-2040
Practice Address - Country:US
Practice Address - Phone:304-400-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty