Individual
BROOKE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 HERBERT ST, PORT ORANGE, FL 32129-6106
(386) 756-0424
Mailing address
1525 HERBERT ST, PORT ORANGE, FL 32129-6106
(386) 756-0424
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
PTA27709
FL
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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