Individual
MATTHEW TAYLOR SAMPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
245 NORTH ST, BRISTOL, VA 24201-3274
(276) 669-4711
Mailing address
609 SPRING HILL RD APT 7, JOHNSON CITY, TN 37604-3879
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5619
TN
Other
Enumeration date
05/30/2017
Last updated
05/30/2017
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