Davis Martin
Occupational Therapist in Woodstock, GA. Individual provider (NPI-1).
NPI number1689366262
StatusActive
Last updated in NPPESMay 23, 2023
Details
- NPI
- 1689366262
- Entity type
- Individual (NPI-1)
- Name
- Davis Martin
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 23, 2023
- Certification date
- May 12, 2023
- Last updated
- May 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 489346 | AL | Yes |
Practice location
4580 Towne Lake PkwyWoodstock, GA 30189-5521
Phone 678-771-6459
Mailing address
2508 Aycock Cemetery RoadLeighton, AL 35646
Phone 970-417-7462
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