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Individual

MRS. ALESIA KATE MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
805 DILWORTH ST, SAINT MARYS, GA 31558-8673
(912) 882-4281
Mailing address
163 WHIPPOORWILL CIR, KINGSLAND, GA 31548-6447
(912) 674-0890

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2306604104
VA
225200000X
Physical Therapy Assistant
Primary
PTA002083
GA
225200000X
Physical Therapy Assistant
PTA21227
FL

Other

Enumeration date
05/21/2015
Last updated
05/21/2015
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