Individual ProviderCorey MatthewsChiropractorChiropractic ProvidersPractice Address403 S 11th St, Suite #110, Boise, ID 83702-6968(208) 343-6900PECOS EnrollmentBased on the most recent information from CMS, provider Corey Matthews does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1407958473Provider TypeIndividualFull NameMatthews, CoreyCredentialD.C.GenderMaleSole ProprietorNoEnumeration Date9/1/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address403 S 11th St, Suite #110, Boise, ID 83702-6968Phone(208) 343-6900Fax(208) 343-0642Mailing LocationMailing AddressPO Box 7442, Boise, ID 83707-1442Phone(208) 343-6900Fax(208) 343-0642Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseCHIA-802IdahoProvider IdentifiersIDDescriptionIssuerIDC1542DescriptionOtherIssuerBLUE CROSSIdahoID000010006850DescriptionOtherIssuerBLUE SHIELDIdaho