Individual
MARTIN OKELBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
674 EASTLAND DR, TWIN FALLS, ID 83301-6846
(208) 734-4264
Mailing address
5540 BANNOCK HWY, POCATELLO, ID 83204-3803
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-3029
ID
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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