Martin, Gwen Marie

Martin, Gwen Marie is an individual health care provider with primary practice located at 500 Hospital Dr , Crestview FL 32539-7355. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Martin, Gwen Marie can be contacted via phone (850) 398-6428.

Contact Information

Primary practice address
500 Hospital Dr Crestview FL 32539-7355
Phone: (850) 398-6428
Fax: (850) 398-6507
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA21573 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA1486 Alabama

Profile Details

NPI number 1164783684
LBN Legal business name Martin, Gwen Marie
Credentials LPTA
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2012
Last updated May 31st, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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