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NPI Code Detail

MEDICARE: DANA MARTIN OT/L

MEDICARE: DANA MARTIN OT/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT883OK

General Provider Information

NPI Number : 1710230131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA MARTIN OT/L
Provider Business Mailing Address
First Line : 10751 SHADY OAKS LN
Second Line :
City : GUTHRIE
State : OK
Zip : 73044-8530
Country : US
Telephone Number : 405-317-3985
Fax Number :
Provider Business Practice Location Address
First Line : 13500 BRANDON PL
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-4312
Country : US
Telephone Number : 405-720-0010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2012
Last Update Date : 10/23/2012

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