Individual
MR. MARK KEVIN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1975 LONG BEACH BLVD, LONG BEACH, CA 90806-5501
(562) 218-4091
(562) 599-3934
Mailing address
12771 MARTHA ANN DR, LOS ALAMITOS, CA 90720-4921
(562) 430-2178
(562) 599-3934
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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