Individual
MATTHEW STEPHEN SUMRALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
6520 SUNSCOPE DR, OCEAN SPRINGS, MS 39564-8690
(228) 875-1177
(228) 872-4009
Mailing address
6520 SUNSCOPE DR, OCEAN SPRINGS, MS 39564-8690
(228) 875-1177
(228) 872-4009
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2602
MS
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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