Provider Demographics
NPI:1871357012
Name:CONATSER, MCKAEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:MCKAEL
Middle Name:
Last Name:CONATSER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 INDUSTRIAL LN
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-6311
Mailing Address - Country:US
Mailing Address - Phone:423-569-3443
Mailing Address - Fax:423-569-2616
Practice Address - Street 1:1010 OLD HIGHWAY 127 S
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-5648
Practice Address - Country:US
Practice Address - Phone:931-879-4066
Practice Address - Fax:931-879-4071
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist