Individual
DAVID A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
3905 W ERNESTINE DR, SUITE B, MARION, IL 62959-5800
(618) 993-6237
(618) 997-3529
Mailing address
3905 W ERNESTINE DR, SUITE B, MARION, IL 62959-5800
(618) 993-6237
(618) 997-3529
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056-006919
STATE LICENSE NO.
IL
01
—
213486
GROUP
IL
Enumeration date
01/03/2008
Last updated
07/11/2011
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