Healthcare Provider Details

I. General information

NPI: 1114256781
Provider Name (Legal Business Name): MATTHEW ALLEN MCCARTNEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 OCOEE ST N
CLEVELAND TN
37312-4829
US

IV. Provider business mailing address

2350 N OCOEE ST
CLEVELAND TN
37311-3850
US

V. Phone/Fax

Practice location:
  • Phone: 423-479-4220
  • Fax:
Mailing address:
  • Phone: 423-476-5554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2395
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: