Matthew R Nicholson, DC Valid NPI
Individual provider · Chiropractor · O Fallon, MO
- NPI
- 1720319817
- Type
- Individual (Type 1)
- Primary specialty
- Chiropractor
- Specialty group
- Chiropractic Providers
- Taxonomy code
- 111N00000X
- License number
- 2010001122 (MO)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2010-01-29
- Last updated
- 2016-01-27
Practice location
2534 Highway K
O Fallon, MO 63368-6625
(636) 978-5511