Provider Demographics
NPI:1003241902
Name:MATT DOPPS CHIROPRACTIC
Entity type:Organization
Organization Name:MATT DOPPS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOPPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-265-1575
Mailing Address - Street 1:555 N. MCLEAN BLVD.
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203
Mailing Address - Country:US
Mailing Address - Phone:316-265-1575
Mailing Address - Fax:316-265-5303
Practice Address - Street 1:555 N. MCLEAN BLVD.
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203
Practice Address - Country:US
Practice Address - Phone:316-265-1575
Practice Address - Fax:316-265-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty