Individual
MATTHEW ALLEN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1904 W BROADWAY AVE, MARYVILLE, TN 37801-5402
(865) 983-8129
(865) 983-8293
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 285-6647
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6157
TN
Other
Enumeration date
11/06/2015
Last updated
11/06/2015
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