Individual
LYDIA ROSE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3261 LUNEMAN RD, PLACERVILLE, CA 95667-8760
(530) 957-0829
Mailing address
3261 LUNEMAN RD, PLACERVILLE, CA 95667-8760
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA50436
CA
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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