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General NPI Number Information
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NPI Number | 1346995362
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE MARTIN OTR
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Gender | Female
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 4200 S 4TH ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5054
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Country | US
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Telephone | 913-727-5527
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Fax |
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Provider Business Mailing Address
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Address Line | 195 CANYON VIEW DR
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City | LANSING
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State | KS
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Zip | 66043-6254
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Country | US
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Telephone | 913-638-3882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-01268
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License Number State | KS
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