Individual
JERRIL MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR, MOT
Contact information
Practice address
2101 W NORTHGATE DR, IRVING, TX 75062
(972) 255-4460
Mailing address
2129 CORAL CT, IRVING, TX 75060-7343
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
118821
TX
225X00000X
Occupational Therapist
19232
CA
Other
Enumeration date
02/05/2019
Last updated
06/03/2019
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