Individual
MATTHEW BRONSON KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1315 RIVERBEND DR APT 109, KINGSPORT, TN 37664-6004
(423) 620-5715
Mailing address
1315 RIVERBEND DR APT 109, KINGSPORT, TN 37664-6004
(423) 620-5715
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3484
TN
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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