Provider Demographics
NPI:1083967830
Name:MCTEER, COREY WILLIMAN (DPT)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:WILLIMAN
Last Name:MCTEER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:2120 W SPRING ST
Practice Address - Street 2:STE 1500
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-3197
Practice Address - Country:US
Practice Address - Phone:678-712-3686
Practice Address - Fax:678-712-3689
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9348225100000X
GAPT010705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist