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General NPI Number Information
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NPI Number | 1811238900
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Entity Type | Organization
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Legal Business Name | MATTHEW C DEMETREE DC, PA
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 3505 S ORLANDO DR
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City | SANFORD
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State | FL
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Zip | 32773-5609
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Country | US
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Telephone | 407-324-8222
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Fax | 407-324-8998
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Provider Business Mailing Address
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Address Line | 3505 S ORLANDO DR
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City | SANFORD
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State | FL
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Zip | 32773-5609
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Country | US
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Telephone | 407-324-8222
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Fax | 407-324-8998
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW C DEMETREE
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Credential | DC
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Telephone | 407-324-8222
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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 | CH7803
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License Number State | FL
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