Healthcare Provider Details

I. General information

NPI: 1023192804
Provider Name (Legal Business Name): MATTHEW JOHN COATS PT, OCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 AIRLINE RD STE 106
ARLINGTON TN
38002-4894
US

IV. Provider business mailing address

6600 STAGE RD STE 129
BARTLETT TN
38134-3838
US

V. Phone/Fax

Practice location:
  • Phone: 901-867-8989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 24279
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0000007122
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: