Provider Demographics
NPI:1336320811
Name:DR VINCENT T MATTIELLO
Entity Type:Organization
Organization Name:DR VINCENT T MATTIELLO
Other - Org Name:HOWLAND CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:T
Authorized Official - Last Name:MATTIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-846-4002
Mailing Address - Street 1:1329 HOWLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-9700
Mailing Address - Country:US
Mailing Address - Phone:407-302-7721
Mailing Address - Fax:407-302-7721
Practice Address - Street 1:1329 HOWLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-9700
Practice Address - Country:US
Practice Address - Phone:407-302-7721
Practice Address - Fax:407-302-7721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9167111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty