Individual
GLENN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
162 GARFIELD PL, SOUTH ORANGE, NJ 07079-2107
(973) 763-0882
Mailing address
162 GARFIELD PL, SOUTH ORANGE, NJ 07079-2107
(973) 763-0882
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
010100-1
NY
Other
Enumeration date
06/27/2012
Last updated
03/14/2014
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