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General NPI Number Information
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NPI Number | 1881137164
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Entity Type | Individual
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Provider Name | ANDREW RYAN MARTIN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 117 S HALCYON RD
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3115
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Country | US
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Telephone | 805-481-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 117 S HALCYON RD
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3115
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Country | US
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Telephone | 805-481-5656
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT013129
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13658-24
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT295371
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License Number State | CA
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