Individual
SUSAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5600 OAKLAND AVE, SAINT LOUIS, MO 63110-1316
(314) 644-9278
Mailing address
4333 BORDEAUX DR, SAINT LOUIS, MO 63129-3811
(314) 892-3339
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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