Individual
ANDY TY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
Mailing address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5491
OK
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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