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General NPI Number Information
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NPI Number | 1336386887
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Entity Type | Organization
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Legal Business Name | MATTHEW RICHTER DC CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 854 MAGNOLIA AVE STE. J
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City | CORONA
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State | CA
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Zip | 92879-3109
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Country | US
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Telephone | 951-817-9815
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Fax |
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Provider Business Mailing Address
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Address Line | 7931 PORT ARTHUR DR
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City | CORONA
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State | CA
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Zip | 92880-3542
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW RICHTER
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Credential | D.C.
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Telephone | 951-817-9815
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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 | DC25172
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License Number State | CA
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