Individual
MRS. ANNA MAE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3033 SARNO RD, MELBOURNE, FL 32934-7229
(321) 610-8979
Mailing address
2954 CHIPPER DR NE, PALM BAY, FL 32905-5705
(321) 557-5728
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
05869
OH
225200000X
Physical Therapy Assistant
2306602044
VA
225200000X
Physical Therapy Assistant
8067
MA
225200000X
Physical Therapy Assistant
A2919
MD
225200000X
Physical Therapy Assistant
Primary
PTA 18514
FL
Other
Enumeration date
03/20/2007
Last updated
03/23/2016
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