Individual
MEGAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3221 BEACON PKWY STE 100, GRANGER, IN 46530-7196
(574) 647-5790
(574) 647-5792
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009595A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201400510
—
IN
Enumeration date
09/14/2016
Last updated
03/30/2021
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