Individual
DIANNE D MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 SW 2D ST, COLLEGE PLACE, WA 99324-1208
(509) 526-0247
Mailing address
621 SW 2D ST, COLLEGE PLACE, WA 99324-1208
(509) 526-0247
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
7710
OR
225200000X
Physical Therapy Assistant
Primary
7710
OR
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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