Healthcare Provider Details

I. General information

NPI: 1407060148
Provider Name (Legal Business Name): MATTHEW ASHKETTLE, D.C.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 AIR WAY RD.
DAYTON OH
45431
US

IV. Provider business mailing address

4325 AIR WAY RD.
DAYTON OH
45431
US

V. Phone/Fax

Practice location:
  • Phone: 614-901-9695
  • Fax: 614-901-9720
Mailing address:
  • Phone: 614-901-9695
  • Fax: 614-901-9720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3257
License Number StateOH

VIII. Authorized Official

Name: DR. MATTHEW P. ASHKETTLE
Title or Position: OWNER
Credential: DC
Phone: 614-901-9695