Provider Demographics
NPI:1568790715
Name:MATTHEW WESTRICH DC PA
Entity Type:Organization
Organization Name:MATTHEW WESTRICH DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WESTRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-492-9075
Mailing Address - Street 1:9550 SW 181ST TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5629
Mailing Address - Country:US
Mailing Address - Phone:305-492-9075
Mailing Address - Fax:305-969-8754
Practice Address - Street 1:9851 E EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5441
Practice Address - Country:US
Practice Address - Phone:305-235-1241
Practice Address - Fax:305-460-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9148261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center