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Organization

WYANDOT CHIROPRACTIC & FITNESS INC.

Active
Other names
Dr. Matthew E Thiel
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW EUGENE THIEL DC (DOCTOR OF CHIROPRACTIC)
(419) 294-3489
Entity
Organization

Contact information

Practice address
109 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-3489
(419) 294-2791
Mailing address
109 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-3489
(419) 294-2791

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
1102
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
$$$$$$$$$
SOCIAL SECURITY NUMBER
OH
01
000000121332
ANTHEM
OH
01
1821004052
NPI (INDIVIDUAL)
OH
01
273645910002
MEDICAL MUTUAL OF OHIO
OH
01
2795088
MEDICAID (INDIVIDUAL)
OH
01
2882911
MEDICAID (GROUP)
OH
01
5840453
OLD AETNA
OH
Enumeration date
08/18/2008
Last updated
05/21/2020
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