Individual
MATTHEW V PROVENZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1790 HAMILL RD, HIXSON, TN 37343-4905
(423) 771-4600
(866) 591-0619
Mailing address
1790 HAMILL RD, HIXSON, TN 37343-4905
(423) 771-4600
(866) 591-0619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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