Provider Demographics
NPI:1174544985
Name:CECCHETTI, MATTHEW ROBERT (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ROBERT
Last Name:CECCHETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 CRIDER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-2385
Mailing Address - Country:US
Mailing Address - Phone:724-625-6325
Mailing Address - Fax:724-625-6328
Practice Address - Street 1:7031 CRIDER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-2385
Practice Address - Country:US
Practice Address - Phone:724-625-6325
Practice Address - Fax:724-625-6328
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor