Provider Demographics
NPI:1316752157
Name:RICE, MATTHEW CHRISTIAN
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHRISTIAN
Last Name:RICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6916 DAKOTA TRL
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-1155
Mailing Address - Country:US
Mailing Address - Phone:952-500-1090
Mailing Address - Fax:
Practice Address - Street 1:6916 DAKOTA TRL
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-1155
Practice Address - Country:US
Practice Address - Phone:952-500-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program