Individual
MR. MATTHEW JON QUINONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5538 NEW CUT RD, LOUISVILLE, KY 40214
(502) 380-1210
(502) 380-1646
Mailing address
5538 NEW CUT RD, LOUISVILLE, KY 40214
(502) 380-1210
(502) 380-1646
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4939
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382602
ANTHEM BC/BS
KY
01
—
11513402
CAQH
KY
01
—
2446185000
PASSPORT ADVANTAGE
KY
01
—
50008038
PASSPORT
—
01
—
681979
GE WELLNESS
—
01
—
7385725
AETNA
—
05
—
85003721
—
KY
Enumeration date
08/28/2006
Last updated
11/15/2007
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