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General NPI Number Information
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NPI Number | 1356022602
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Entity Type | Individual
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Provider Name | CALI-MICHELLE MARTIN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 11/28/2024
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Provider Practice Location Address
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Address Line | 2017 W I 35 FRONTAGE RD STE 220
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City | EDMOND
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State | OK
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Zip | 73013-8560
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Country | US
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Telephone | 405-757-3380
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Fax |
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Provider Business Mailing Address
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Address Line | 4607 N PENNSYLVANIA AVE APT 1A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-8935
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Country | US
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Telephone |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 6413
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License Number State | OK
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