Individual
CASEY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
68 ALEKSANDER BLVD, WILKES BARRE, PA 18707-9233
(570) 592-7455
Mailing address
68 ALEKSANDER BLVD, WILKES BARRE, PA 18707-9233
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363AM0700X
Medical Physician Assistant
Primary
MA065925
PA
Other
Enumeration date
06/26/2015
Last updated
10/24/2024
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