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Individual

DR. MATTHEW MICHAEL ANTONUCCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C., D.A.C.N.B

Contact information

Practice address
874 WHIPPLE RD, SUITE 200, MOUNT PLEASANT, SC 29464-8900
(843) 882-5433
Mailing address
874 WHIPPLE RD, SUITE 200, MOUNT PLEASANT, SC 29464-8900
(843) 882-5433

Taxonomy

Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
3613
SC
111NN1001X
Nutrition Chiropractor
3613
SC
111NP0017X
Pediatric Chiropractor
3613
SC

Other

Enumeration date
01/18/2011
Last updated
01/18/2011
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