Individual
LISA T MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
110 PLEASANT AVE S, PARK RAPIDS, MN 56470-1415
(218) 237-3052
Mailing address
1425 S COLUMBIA RD, GRAND FORKS, ND 58201-4039
(701) 746-8374
(701) 780-0885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6029
MN
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376864603
—
MN
Enumeration date
06/22/2010
Last updated
09/04/2019
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