Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2011026702 | MO |
N | 111NR0400X | Rehabilitation Chiropractor | S03878 | MD |
NPI | 1215234513 |
---|---|
Provider Name | Dr. Matthew Lee Hecht |
First Address | Crofton, MD 21114-2472 |
Second Address | Crofton, MD 21114-2472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2011 |
Last Update Date | 08/12/2017 |