Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4095 | OH |
NPI | 1003120049 |
---|---|
Provider Name | Dr. Matthew Richard Rivers |
First Address | Cleveland, OH 44103-4226 |
Second Address | Cleveland, OH 44103-4226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2010 |
Last Update Date | 28/04/2015 |