Individual
MS. ELAINE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
405 AUGUSTA ST, RACINE, WI 53402-4405
(262) 751-9655
Mailing address
405 AUGUSTA ST, RACINE, WI 53402-4405
(262) 751-9655
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1306-19
WI
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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