Individual
MICHAEL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
4450 SMACKOVER HWY, SMACKOVER, AR 71762-9533
(870) 725-2497
(870) 725-2517
Mailing address
1098 OLD STRONG HWY, STRONG, AR 71765-9560
(870) 797-7802
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1447
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156989721
—
AR
01
—
5Y181
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/30/2007
Last updated
02/02/2019
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