Provider Demographics
NPI:1770011629
Name:KACHEL, MATHEW JOHN (DC)
Entity Type:Individual
Prefix:
First Name:MATHEW
Middle Name:JOHN
Last Name:KACHEL
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 1:1020 W WISCONSIN ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-2230
Mailing Address - Country:US
Mailing Address - Phone:608-269-8145
Mailing Address - Fax:608-269-8147
Practice Address - Street 1:125 N WEINBACH AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-6091
Practice Address - Country:US
Practice Address - Phone:812-470-5640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002969A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor