Individual
MARIA RENEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LTA, LE
Contact information
Practice address
132 E BROADWAY STE 718, EUGENE, OR 97401-3159
(541) 543-6868
Mailing address
132 E BROADWAY STE 718, EUGENE, OR 97401-3159
(541) 543-6868
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
BAP-TA-10166654
OR
Other
Enumeration date
06/22/2023
Last updated
07/21/2023
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