Individual
MATTHEW D STIMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPED, CPOA, CFO
Contact information
Practice address
2435 JACKSBORO PIKE STE 3, LA FOLLETTE, TN 37766-2912
(423) 449-8135
Mailing address
1708 CLAIRE STEVENS CIR, KNOXVILLE, TN 37931-4552
(865) 256-6288
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
PED109
TN
225000000X
Orthotic Fitter
CFO03775
TN
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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