Individual
LARRY J MATNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1501 S MAIN ST, OTTAWA, KS 66067-3802
(785) 242-4100
(785) 242-4121
Mailing address
1501 S MAIN ST, OTTAWA, KS 66067-3802
(785) 242-4100
(785) 242-4121
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-03054
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4657100
AETNA
KS
01
—
481174803
TAX IDENTIFICATION
KS
Enumeration date
08/30/2006
Last updated
07/08/2007
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