Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT011373 | GA |
N | 2251N0400X | Physical Therapist - Neurology | PT011373 | GA |
NPI | 1407254253 |
---|---|
Provider Name | Naja Saleem Martin |
First Address | Lawrenceville, GA 30045-5440 |
Second Address | Lawrenceville, GA 30045-5440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2014 |
Last Update Date | 10/12/2014 |