Individual
JUSTIN JEFFERSON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
151 ROYAL DR, HEWITT, TX 76643-2959
(254) 420-1400
Mailing address
302 W PECAN ST, WEST, TX 76691-1331
(254) 855-4003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
218163
TX
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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