Provider Demographics
NPI:1164847703
Name:MATTIX, CATHERINE (LMT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MATTIX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6980
Mailing Address - Country:US
Mailing Address - Phone:423-470-4363
Mailing Address - Fax:
Practice Address - Street 1:205 UNION ST
Practice Address - Street 2:SUITE 6
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1179
Practice Address - Country:US
Practice Address - Phone:423-470-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10473225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist