Individual
MALLORY L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2300 S OAK GROVE RD, ENNIS, TX 75119-6841
(972) 875-8643
Mailing address
201 JANIS LN, WAXAHACHIE, TX 75165-6061
(972) 921-4883
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4059062
TX
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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