Individual
LUCAS MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
137 MAPLETON RIDGE DR NW, CLEVELAND, TN 37312-6011
(865) 803-6988
Mailing address
137 MAPLETON RIDGE DR NW, CLEVELAND, TN 37312-6011
(865) 803-6988
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4848
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4848
STATE LICENSE
TN
Enumeration date
04/05/2020
Last updated
04/05/2020
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