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Individual

KENNETH MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 449-0391
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 449-0391

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
08500
MD
225X00000X
Occupational Therapist
225XM0800X
Mental Health Occupational Therapist

Other

Enumeration date
06/15/2018
Last updated
02/22/2022
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