Provider Demographics
NPI:1780782656
Name:SIBLEY, MATTHEW D (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:SIBLEY
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 1:900 E ATLANTIC AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6954
Mailing Address - Country:US
Mailing Address - Phone:561-272-4100
Mailing Address - Fax:561-272-8702
Practice Address - Street 1:900 E ATLANTIC AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6954
Practice Address - Country:US
Practice Address - Phone:561-272-4100
Practice Address - Fax:561-272-8702
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55211Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER