Gwen Marie Martin, LPTA

NPI #1164783684 in Crestview, Florida

Provider Information

NPI Number: 1164783684
Entity Type: Individual
Name: Gwen Marie Martin, LPTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: LPTA
Enumeration Date: May 31, 2012
Last Updated: May 31, 2012

Practice Location

Address: 500 HOSPITAL DR
City: Crestview
State: Florida
ZIP Code: 32539-7355
Phone: (850) 398-6428

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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