Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR008202 | GA |
N | 111NI0013X | Independent Medical Examiner | CHIR008202 | GA |
N | 111NN1001X | Nutrition | CHIR008202 | GA |
N | 111NR0400X | Rehabilitation Chiropractor | CHIR008202 | GA |
N | 111NS0005X | Chiropractic Sports Physician | CHIR008202 | GA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | CHIR008202 | GA |
NPI | 1194809103 |
---|---|
Provider Name | Dr. Arthur Lee Matthews III |
First Address | Marietta, GA 30060-6340 |
Second Address | Atlanta, GA 30305-1836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 13/09/2019 |