Individual
MYRABELLE MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 WOOD ST, SISTERSVILLE, WV 26175-1523
(304) 652-1032
Mailing address
207 STEPHENS ST, PADEN CITY, WV 26159-1520
(304) 337-4006
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001167
WV
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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