Individual
MARK DAVID MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
410 N 2ND ST, MARSHALL, IL 62441-1010
(217) 826-2358
Mailing address
235 W MADISON ST APT 4, PARIS, IL 61944-2174
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.006158
IL
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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