Individual
DR. MATTHEW COLONNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
802 S BROADWAY ST, PORTLAND, TN 37148-1622
(615) 323-7331
(615) 323-7332
Mailing address
323 VAN CONDER PL, HENDERSONVILLE, TN 37075-2852
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000003532
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD0000003532
OD LICENSE NUMBER
TN
Enumeration date
07/15/2019
Last updated
06/20/2022
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