Wallis, Matthew C
Wallis, Matthew C is an individual health care provider with primary practice located at 2725 James Sanders Blvd Suite A, Paducah KY 42001-8401. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wallis, Matthew C can be contacted via phone (270) 554-5114.Contact Information
Primary practice address
2725 James Sanders Blvd Suite A
Paducah KY 42001-8401
Phone: (270) 554-5114
Fax: (270) 554-5021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 4456 | Kentucky |
Profile Details
| NPI number | 1851499388 |
|---|---|
| LBN Legal business name | Wallis, Matthew C |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Feb 16th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851499388 | NPPES |
| Kentucky | Other | 611375366 | TAX ID |
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