Individual
AVERY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1305 MOORE ST, PHILADELPHIA, PA 19148-1508
(706) 247-9726
Mailing address
1305 MOORE ST, PHILADELPHIA, PA 19148-1508
(706) 247-9726
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC017534
PA
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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