Individual
MRS. MARTHA JEAN POAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 HIGH POINT DR, KANE, PA 16735-9704
(814) 975-1245
(814) 837-9205
Mailing address
100 HIGH POINT DR, KANE, PA 16735-9704
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006439
PA
Other
Enumeration date
06/27/2014
Last updated
06/27/2014
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