Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NP0017X | Pediatric Chiropractor | 2014000855 | MO |
Y | 111NS0005X | Chiropractic Sports Physician | 2014000855 | MO |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 2014000855 | MO |
NPI | 1912329897 |
---|---|
Provider Name | Matthew Mcfarland |
First Address | West Plains, MO 65775-2533 |
Second Address | West Plains, MO 65775-2533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2014 |
Last Update Date | 13/01/2014 |