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General NPI Number Information
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NPI Number | 1104129691
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Entity Type | Organization
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Legal Business Name | MATTHEW C. RICH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 6247 CLEARFIELD WOODLAND HWY
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City | CLEARFIELD
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State | PA
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Zip | 16830-1004
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Country | US
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Telephone | 814-765-8301
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Fax | 814-768-4735
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Provider Business Mailing Address
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Address Line | PO BOX 647
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City | CLEARFIELD
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State | PA
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Zip | 16830-0647
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Country | US
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Telephone | 814-765-8301
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Fax | 814-768-4735
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. MATTHEW C. RICH
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Credential | D.C.
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Telephone | 814-765-8301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-8651
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License Number State | PA
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