Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08002167A | IN |
NPI | 1003842923 |
---|---|
Provider Name | Dr. Matthew Charles Ferris |
First Address | Indianapolis, IN 46256-1459 |
Second Address | Indianapolis, IN 46256-1459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 15/12/2021 |