Provider Demographics
NPI:1346778164
Name:PAPPICCO, MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:PAPPICCO
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 1:961 N MAIN ST # 212
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-2188
Mailing Address - Country:US
Mailing Address - Phone:201-417-7655
Mailing Address - Fax:
Practice Address - Street 1:691 LANCASTER BYP E
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-4727
Practice Address - Country:US
Practice Address - Phone:803-419-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor