Individual
MR. RANDY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(888) 873-4221
Mailing address
200 BENFIELD RD, STATESVILLE, NC 28677-9308
(704) 872-1519
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4016
NC
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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