Provider Demographics
NPI:1487624847
Name:DORCHESTER, MATTHEW RYDER (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:RYDER
Last Name:DORCHESTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8894 E RUSTY SPUR PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9166
Mailing Address - Country:US
Mailing Address - Phone:480-991-3399
Mailing Address - Fax:480-905-0815
Practice Address - Street 1:18325 N ALLIED WAY
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-3105
Practice Address - Country:US
Practice Address - Phone:480-991-3399
Practice Address - Fax:480-905-0815
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4478111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician