Healthcare Provider Details

I. General information

NPI: 1962583237
Provider Name (Legal Business Name): AFFINITY FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 CRIDER RD SUITE 102
MARS PA
16046-2385
US

IV. Provider business mailing address

7031 CRIDER RD SUITE 102
MARS PA
16046-2385
US

V. Phone/Fax

Practice location:
  • Phone: 724-625-6325
  • Fax: 724-625-6328
Mailing address:
  • Phone: 724-625-6325
  • Fax: 724-625-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009518
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MATTHEW ROBERT CECCHETTI
Title or Position: MEMBER
Credential: D.C, C.C.E.P.
Phone: 724-625-6325