Individual
MATTHEW RYAN BULLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
542 ALLRED MILL RD, MOUNT AIRY, NC 27030-2202
(336) 789-5076
Mailing address
114 WILDCAT RD, HILLSVILLE, VA 24343-1950
(276) 733-0374
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0131000294
VA
224Z00000X
Occupational Therapy Assistant
Primary
9779
NC
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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