Provider Demographics
NPI:1104191618
Name:REPPERT, MATTHEW C (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:REPPERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 E EMMAUS AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4422
Mailing Address - Country:US
Mailing Address - Phone:610-791-0120
Mailing Address - Fax:610-791-9691
Practice Address - Street 1:1850 E EMMAUS AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4422
Practice Address - Country:US
Practice Address - Phone:610-791-0120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor