Individual
MS. KIMBERLY ANNE MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1008 THOMPSON ST, JERSEY SHORE, PA 17740-1729
(570) 398-4747
Mailing address
225 DELAWARE DR, WATSONTOWN, PA 17777-9715
(570) 220-9082
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC005616L
PA
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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