Individual
MRS. REBECCA LYNN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
176 W MOUND RD, DECATUR, IL 62526-1964
(217) 875-0163
Mailing address
176 W MOUND RD, DECATUR, IL 62526-1964
(217) 875-0163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003480
IL
Other
Enumeration date
07/03/2009
Last updated
01/06/2022
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