Charles Matthew Street, PA

NPI #1255981940 in Oak Ridge, Tennessee

Provider Information

NPI Number
1255981940
Entity Type
Individual
Name
Charles Matthew Street, PA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant - Medical
Credential
PA
Enumeration Date
Sep 16, 2019
Last Updated
Sep 16, 2019

Practice Location

Address
170 W TENNESSEE AVE
ZIP Code
37830-6509
Phone
(865) 482-1788

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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