Provider Demographics
NPI:1255086724
Name:GIESSMAN, MATTHEW ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ANTHONY
Last Name:GIESSMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 RAY ST STE A
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6649
Mailing Address - Country:US
Mailing Address - Phone:925-484-0191
Mailing Address - Fax:
Practice Address - Street 1:148 RAY ST STE A
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6649
Practice Address - Country:US
Practice Address - Phone:925-484-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor