Individual
MARTHA COWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
3519 S BAILEYVILLE RD, FREEPORT, IL 61032-9731
(815) 541-7740
(815) 232-8763
Mailing address
1341 EMPIRE CT, FREEPORT, IL 61032
(815) 541-7740
(815) 232-8763
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056000666
IL
Other
Enumeration date
10/02/2006
Last updated
02/03/2015
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