Provider Demographics
NPI:1144024829
Name:MATIAS HEALTH CHIROPRACTIC II LLC
Entity type:Organization
Organization Name:MATIAS HEALTH CHIROPRACTIC II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:470-800-4041
Mailing Address - Street 1:10800 ALPHARETTA HWY STE 208-588
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1490
Mailing Address - Country:US
Mailing Address - Phone:470-800-4041
Mailing Address - Fax:470-403-4014
Practice Address - Street 1:2310 BROCKETT RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4416
Practice Address - Country:US
Practice Address - Phone:470-800-4041
Practice Address - Fax:403-403-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty