Individual
JENNY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3044 DUE WEST RD, DALLAS, GA 30157-2125
(770) 443-9672
(770) 505-3595
Mailing address
3044 DUE WEST RD, DALLAS, GA 30157-2125
(770) 443-9672
(770) 505-3595
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006689
GA
Other
Enumeration date
03/03/2017
Last updated
03/03/2017
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