Individual
MICHAEL D CAVANAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1043 JACK VEST DR, JOHNSON CITY, TN 37614
(423) 439-4044
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15518
TN
225100000X
Physical Therapist
PT013061
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT013061
PT LICENSE
GA
05
—
Q090248
—
TN
Enumeration date
08/03/2017
Last updated
08/13/2024
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