Provider Demographics
NPI:1417182643
Name:MAGEE, MATTHEW (PT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:MAGEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 GROVE ST
Mailing Address - Street 2:STE 120
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-3251
Mailing Address - Country:US
Mailing Address - Phone:865-458-8080
Mailing Address - Fax:
Practice Address - Street 1:1125 GROVE ST
Practice Address - Street 2:STE 120
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-3251
Practice Address - Country:US
Practice Address - Phone:865-458-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000006677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist