Provider Demographics
NPI:1922120310
Name:RABER, MATTHEW T (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:RABER
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 1:2624 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-2307
Mailing Address - Country:US
Mailing Address - Phone:215-872-5657
Mailing Address - Fax:215-361-1098
Practice Address - Street 1:2624 PENN AVE
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-2307
Practice Address - Country:US
Practice Address - Phone:215-872-5657
Practice Address - Fax:215-361-1098
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC08639L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor