Individual
TERRA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2350 KANELL BLVD, POPLAR BLUFF, MO 63901-4036
(573) 785-0188
Mailing address
73 OXEN PASTURE RD, DONIPHAN, MO 63935-9453
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2008020769
MO
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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