Individual
DR. R. MARTIN MATISCIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
914 TRAILWOOD DR, BOARDMAN, OH 44512-5007
(330) 758-6440
(330) 758-6990
Mailing address
914 TRAILWOOD DR, BOARDMAN, OH 44512-5007
(330) 758-6440
(330) 758-6990
Taxonomy
Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
Primary
2192
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000229020
ANTHEM
OH
01
—
000000350553
ANTHEM
OH
05
—
0190270
—
OH
01
—
268261599010
MEDICAL MUTUAL
OH
Enumeration date
11/13/2006
Last updated
07/08/2007
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