Provider Demographics
NPI:1053698092
Name:MCCART, MATTHEW PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PAUL
Last Name:MCCART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5701 UTICA RIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2914
Mailing Address - Country:US
Mailing Address - Phone:563-424-4564
Mailing Address - Fax:888-893-9886
Practice Address - Street 1:5701 UTICA RIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2914
Practice Address - Country:US
Practice Address - Phone:563-424-4564
Practice Address - Fax:888-893-9886
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0107015Medicaid