Individual
MYRA E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
103 W 13TH ST, GROVE, OK 74344-3224
(918) 786-2276
(918) 786-2276
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(800) 944-9782
(610) 438-2024
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
315
OK
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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