Individual
MISS SHELLI MARIE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
590 POPLAR FORK RD, HURRICANE, WV 25526-9434
(304) 757-7826
(304) 757-8861
Mailing address
2013 MONA CT, MILTON, WV 25541-1024
(304) 638-5410
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000707
WV
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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