Individual
MARTHA E KOGLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
24 E SPRING ST, PORT AUSTIN, MI 48467-6736
(989) 738-5222
(989) 738-5224
Mailing address
24 E SPRING ST, PORT AUSTIN, MI 48467-6736
(989) 738-5222
(989) 738-5224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005895
MI
Other
Enumeration date
09/27/2010
Last updated
03/21/2013
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