Individual
KRISTA C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4990
(262) 245-2248
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4990
(262) 245-2248
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057-003627
IL
224Z00000X
Occupational Therapy Assistant
Primary
4922-27
WI
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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