Individual
ROBERTA RUTH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4800 MEXICO RD STE 104, SAINT PETERS, MO 63376-1666
(636) 939-9540
(636) 939-9886
Mailing address
607 DEWEY AVE NW STE 300, GRAND RAPIDS, MI 49504-7335
(616) 356-5000
(616) 356-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2019000881
MO
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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