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General NPI Number Information
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NPI Number | 1962519173
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Entity Type | Individual
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Provider Name | CATHLEEN DITTON MATTOS DC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8 FOX RUN LANE
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301
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Country | US
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Telephone | 570-223-1650
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Fax | 570-223-8235
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Provider Business Mailing Address
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Address Line | 8 FOX RUN LANE
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301
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Country | US
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Telephone | 570-223-1650
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Fax | 570-223-8235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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-006904-R
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License Number State | PA
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