Provider Demographics
NPI:1902149735
Name:SALIM, MATTHEW (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SALIM
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:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:ARCHER CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76351-0027
Mailing Address - Country:US
Mailing Address - Phone:940-337-0811
Mailing Address - Fax:888-976-5773
Practice Address - Street 1:101 S. CENTER ST. SUITE A
Practice Address - Street 2:
Practice Address - City:ARCHER CITY
Practice Address - State:TX
Practice Address - Zip Code:76351
Practice Address - Country:US
Practice Address - Phone:940-337-0811
Practice Address - Fax:888-976-5773
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor