MEDICARE: MRS. MARTHA MICHELLE SLIMP PHYSICAL THERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1135184	TX

General Provider Information

NPI Number	:	1295885903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA MICHELLE SLIMP PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	7500 ORRICK DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-2607
Country	:	US
Telephone Number	:	512-301-0076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 W BEN WHITE BLVD
Second Line	:	SUITE 100B
City	:	AUSTIN
State	:	TX
Zip	:	78704-7667
Country	:	US
Telephone Number	:	512-440-1441
Fax Number	:	512-440-1448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2007

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