Provider Demographics
NPI:1447529110
Name:OTEY, MATTHEW E (PT, DT, CERT DN)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:E
Last Name:OTEY
Suffix:
Gender:M
Credentials:PT, DT, CERT DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 W WASHINGTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-1248
Mailing Address - Country:US
Mailing Address - Phone:706-343-4444
Mailing Address - Fax:707-736-7250
Practice Address - Street 1:271 W WASHINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-1248
Practice Address - Country:US
Practice Address - Phone:706-343-4444
Practice Address - Fax:707-736-7250
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist