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General NPI Number Information
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NPI Number | 1578686531
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Entity Type | Individual
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Provider Name | DOLORES L. MARTIN PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2841 NEAL METCALF RD
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City | ENTERPRISE
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State | AL
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Zip | 36330-8003
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Country | US
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Telephone | 334-393-1011
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Fax | 334-347-3124
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Provider Business Mailing Address
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Address Line | 104 MINA ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-1413
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Country | US
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Telephone | 334-347-3714
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | AL1629
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License Number State | AL
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