Individual
OLIVIA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5757
(601) 579-5220
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5757
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6102
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01906560
—
MS
Enumeration date
07/18/2016
Last updated
07/23/2020
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