Individual
MR. COREY ANDRE' MARTIN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1240 FLOY FARR PARKWAY, SUITE 404, FAYETTEVILLE, GA 30214
(470) 670-0485
Mailing address
3690 SPRINGSIDE LN, COLLEGE PARK, GA 30349-3550
(404) 825-3374
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA005116
GA
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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