Individual
KATHLEEN RACHELLE MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
378 MARKETPLACE DR STE 5, JOHNSON CITY, TN 37604-2361
(423) 282-0751
(423) 282-1577
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/18/2016
Last updated
11/24/2023
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