Individual
MR. MATTHEW J DICERBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1210 GREEN OAKS LN APT J, CHARLOTTE, NC 28205-8325
(704) 451-1403
Mailing address
1210 GREEN OAKS LN APT J, CHARLOTTE, NC 28205-8325
(704) 451-1403
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5427
NC
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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