Individual
MATTHEW JON CARBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
5022 OLD GODSEY LN, SUITE 3, HIXSON, TN 37343-6600
(423) 870-3573
(423) 870-3574
Mailing address
1790 HAMILL RD, HIXSON, TN 37343-5180
(423) 842-9322
(866) 591-0619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446652
—
TN
01
—
3156797
BCBST - GROUP NUMBER
TN
05
—
5441441
—
TN
01
—
6649
TN PT LICENSE
TN
01
—
PT007437
GA PT LICENSE
GA
Enumeration date
06/02/2006
Last updated
03/30/2016
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