Individual
MATTHEW JASON BOUDRERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT, OTR/L
Contact information
Practice address
5121 COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-7570
Mailing address
2721 NORA DR, SALT LAKE CITY, UT 84124-2025
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7080114-4201
UT
Other
Enumeration date
11/27/2010
Last updated
11/27/2010
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