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Michael Martinez, PTA

Physical Therapy Assistant in Orland Park, IL. Individual provider (NPI-1).

NPI number1760601678
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1760601678
Entity type
Individual (NPI-1)
Name
Michael Martinez
Credential
PTA
Sex
Male
Sole proprietor
No
Enumeration date
Apr 25, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant160004655ILYes

Practice location

16170 Kingsport Rd
Orland Park, IL 60467-5602

Phone 708-349-6544

Mailing address

2934 Desplaines Ave
Riverside, IL 60546-1852

Phone 708-349-6544

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