Individual
KELLY GROTE MATUTINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
650 N JEFFERSON ST, ROANOKE, VA 24016-1427
(540) 345-5111
Mailing address
5668 MEADOWCREST ST, ROANOKE, VA 24019-4816
(928) 234-8429
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119002058
VA
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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