Provider Demographics
NPI:1013096965
Name:TERRERI, MATTHEW NORMAN (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:NORMAN
Last Name:TERRERI
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 1:240 E HERSEY ST STE 0
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-5202
Mailing Address - Country:US
Mailing Address - Phone:541-482-0625
Mailing Address - Fax:541-482-3364
Practice Address - Street 1:240 E HERSEY ST STE 0
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-5202
Practice Address - Country:US
Practice Address - Phone:541-482-0625
Practice Address - Fax:541-482-3364
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1245537521OtherN/A