Provider Demographics
NPI:1174064372
Name:MATTHEWS, ALYSSA CHRISTINE (DC)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:CHRISTINE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-1531
Mailing Address - Country:US
Mailing Address - Phone:262-337-5649
Mailing Address - Fax:262-462-0608
Practice Address - Street 1:47 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1531
Practice Address - Country:US
Practice Address - Phone:262-337-5649
Practice Address - Fax:262-462-0608
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5258 - 12111N00000X
WI5258-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor