Individual
MICHAEL PAUL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 N LAKE ST, PESHTIGO, WI 54157-1013
(715) 582-3906
Mailing address
501 N LAKE ST, PESHTIGO, WI 54157-1013
(715) 582-3906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2629-19
WI
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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