Provider Demographics
NPI:1649456930
Name:PARRIS, MATTHEW N (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:N
Last Name:PARRIS
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 1:1867 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3573
Mailing Address - Country:US
Mailing Address - Phone:772-569-0830
Mailing Address - Fax:772-569-9914
Practice Address - Street 1:1867 20TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3573
Practice Address - Country:US
Practice Address - Phone:772-569-0830
Practice Address - Fax:772-569-9914
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2220994OtherFIRST HEALTH
FL70153Medicare PIN
FL2220994OtherFIRST HEALTH