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General NPI Number Information
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NPI Number | 1902018245
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Entity Type | Individual
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Provider Name | RODNEY G MARTIN RPTA
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Gender | Male
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Dates
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Enumeration Date | 05/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 HEALTH CENTER PKWY
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City | YUKON
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State | OK
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Zip | 73099-6381
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Country | US
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Telephone | 405-717-6979
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Fax |
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Provider Business Mailing Address
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Address Line | 971 SW 4TH PL
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City | MOORE
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State | OK
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Zip | 73160-2217
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Country | US
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Telephone | 405-237-1192
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA213
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License Number State | OK
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