Individual
GREGORY LUIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4060 FOURTH AVE STE 206, SAN DIEGO, CA 92103-2120
(619) 299-5246
Mailing address
1812 REED AVE, SAN DIEGO, CA 92109-5476
(916) 719-5690
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 10877
CA
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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