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NPI Code Detail

MEDICARE: MATHEW DEVILLE CHIROPRACTIC, P.C.

MEDICARE: MATHEW DEVILLE CHIROPRACTIC, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor29908CA

General Provider Information

NPI Number : 1902247216
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATHEW DEVILLE CHIROPRACTIC, P.C.
Provider Business Mailing Address
First Line : 1981 ARTESIA BLVD
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-2907
Country : US
Telephone Number : 310-504-0013
Fax Number :
Provider Business Practice Location Address
First Line : 1981 ARTESIA BLVD
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-2907
Country : US
Telephone Number : 310-504-0013
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MATHEW JAMES DEVILLE
Credential : DC
Telephone Number : 310-504-0013
Provider Enumeration Date : 07/15/2013
Last Update Date : 06/11/2019

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Directions to “MATHEW DEVILLE CHIROPRACTIC, P.C. ” Practice Location

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