| Doctor Name: | DR. MATTHEW JOSEPH ROLLER |
| NPI Number: | 1033283379 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | PT10400 |
| Business Practice Address: | 1000 S Columbia Rd Grand Forks, ND - 582014036 |
| Business Phone Number: | 7017806000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 6002, GRAND FORKS |
| State: | ND |
| Postal Code: | 582066002 |
| Phone Number: | 7017806000 |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2006 |
| NPI Last Update Date: | 10/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | PT10400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |