Provider Demographics
NPI:1780006981
Name:CAHOON, MATTHEW (MS, LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:CAHOON
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 BRANNER AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-2210
Mailing Address - Country:US
Mailing Address - Phone:865-471-3515
Mailing Address - Fax:865-471-4443
Practice Address - Street 1:2130 BRANNER AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2210
Practice Address - Country:US
Practice Address - Phone:865-471-3515
Practice Address - Fax:865-471-4443
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000016262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer