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NPI Code Detail

MEDICARE: MATTHEW PEDROTTI DPT

MEDICARE: MATTHEW PEDROTTI DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT010852GA

General Provider Information

NPI Number : 1588918031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW PEDROTTI DPT
Provider Business Mailing Address
First Line : 8823 PRODUCTION LN
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-6511
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 1275 HIGHWAY 54 W STE 200
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-4538
Country : US
Telephone Number : 770-460-8609
Fax Number : 770-460-8629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2012
Last Update Date : 11/06/2012

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Directions to “ MATTHEW PEDROTTI DPT” Practice Location

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