Provider Demographics
NPI:1467990952
Name:MATTHEWS, TED III (DC)
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:
Last Name:MATTHEWS
Suffix:III
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 1:905 HAMLET CT
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3356
Mailing Address - Country:US
Mailing Address - Phone:724-961-0678
Mailing Address - Fax:
Practice Address - Street 1:905 HAMLET CT
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3356
Practice Address - Country:US
Practice Address - Phone:724-961-0678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011228111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation