Individual
WALTER SCOTT MATLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
520 OLD HIGHWAY 68, SWEETWATER, TN 37874-6258
(423) 351-1050
Mailing address
19395 FORK CREEK RD., PHILADELPHIA, TN 37846
(865) 414-0851
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6842
TN
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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