Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 10604 | NC |
NPI | 1003014747 |
---|---|
Provider Name | Mrs. Rebekah A Martin |
First Address | Henderson, NC 27536-1696 |
Second Address | Henderson, NC 27536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 20/12/2007 |