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Individual

DR. MATTHEW DAVID WITTWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
477181 HIGHWAY 95 STE B, PONDERAY, ID 83852-5009
(208) 597-4033
Mailing address
477181 HIGHWAY 95 STE B, PONDERAY, ID 83852-5009
(208) 597-4033

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
34674
CA
111N00000X
Chiropractor
Primary
CHIA-2152
ID

Other

Enumeration date
11/05/2019
Last updated
06/09/2022
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