Individual
MR. MATTHEW PULISIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT MS OCS
Contact information
Practice address
203 N WASHINGTON HWY, ASHLAND, VA 23005
(804) 340-1193
(804) 340-1930
Mailing address
203 N WASHINGTON HWY, ASHLAND, VA 23005-1623
(804) 798-1112
(804) 798-1171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305003929
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010330483
—
VA
05
—
8941653
—
VA
Enumeration date
03/14/2006
Last updated
10/16/2019
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