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Individual

CHARLOTTE MARIE MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3731 W COOK RD, FORT WAYNE, IN 46818-9662
(317) 204-3736
(317) 449-5783
Mailing address
5095 HAMMOCK DR, FORT WAYNE, IN 46818-8570
(615) 772-7072

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
10/12/2021
Last updated
10/12/2021
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