Provider Demographics
NPI:1952653354
Name:PLATT, MATTHEW DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DEAN
Last Name:PLATT
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 1:5050 STATE HWY 303
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311
Mailing Address - Country:US
Mailing Address - Phone:360-627-7408
Mailing Address - Fax:
Practice Address - Street 1:7304 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3722
Practice Address - Country:US
Practice Address - Phone:502-933-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor