Matthew Cahoon, MS, LAT, ATC

Individual provider Active NPI Athletic Trainer · Jefferson City, TN

NPI 1780006981 · NPPES record last updated Jan 8, 2014

Key facts

NPI
1780006981
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
0000001626 (TN)
Practice address
2130 Branner Ave
Jefferson City, TN 37760-2210
Phone
(865) 471-3515
Fax
(865) 471-4443
NPI assigned
Jan 8, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0000001626TNMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0000001626 TN Yes

Addresses

Primary practice location

2130 Branner Ave
Jefferson City, TN 37760-2210

Mailing address

2130 Branner Ave
Jefferson City, TN 37760-2210
Phone (865) 471-3515

Other providers in Jefferson City, TN

All providers in Jefferson City, TN · Athletic Trainer in Tennessee

Sources for this page

Verify at the official NPI Registry.