Healthcare Provider Details

I. General information

NPI: 1700513173
Provider Name (Legal Business Name): CAMERON ALLEN MATHENY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 04/02/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 OAK RIDGE HWY STE 3
KNOXVILLE TN
37931-2345
US

IV. Provider business mailing address

7811 OAK RIDGE HWY STE 3
KNOXVILLE TN
37931-2345
US

V. Phone/Fax

Practice location:
  • Phone: 865-313-2445
  • Fax: 865-313-2455
Mailing address:
  • Phone: 865-230-3243
  • Fax: 423-419-5506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0000015504
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: