Healthcare Provider Details

I. General information

NPI: 1235207465
Provider Name (Legal Business Name): JAMES PATRICK MATCHETT D.C., ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 N SALISBURY BLVD
SALISBURY MD
21801-4103
US

IV. Provider business mailing address

34 LOOKOUT POINT
BERLIN MD
21811
US

V. Phone/Fax

Practice location:
  • Phone: 703-298-0041
  • Fax:
Mailing address:
  • Phone: 703-298-0903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number03838
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number0104002090
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number03838
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: