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General NPI Number Information
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NPI Number | 1467598359
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Entity Type | Individual
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Provider Name | MICHELE MARTIN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 6020 WARDEN RD STE 230
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City | SHERWOOD
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State | AR
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Zip | 72120
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Country | US
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Telephone | 501-392-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 6020 WARDEN RD STE 230
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City | SHERWOOD
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State | AR
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Zip | 72120-6068
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Country | US
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Telephone | 501-392-9180
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1238
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License Number State | AR
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