Provider Demographics
NPI:1831343094
Name:SKAHILL, MATTHEW G (MAC, LAC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:G
Last Name:SKAHILL
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 N FRANKLIN ST
Mailing Address - Street 2:2 REAR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2723
Mailing Address - Country:US
Mailing Address - Phone:215-264-5575
Mailing Address - Fax:
Practice Address - Street 1:712 N FRANKLIN ST
Practice Address - Street 2:2 REAR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-2723
Practice Address - Country:US
Practice Address - Phone:215-264-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000943171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist