Individual
DANA M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1651 W ROSEDALE, SUITE 200, FORT WORTH, TX 76104-7437
(817) 810-0001
(817) 810-0054
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 810-0054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1136364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172528501
—
TX
01
—
P00254140
RAILROAD MEDICARE
—
Enumeration date
07/17/2006
Last updated
09/30/2011
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