| Lemuel C & Elmezen Martin | |
|
422 Lakeport Blvd, Lakeport, CA 95453-5404 | |
| (707) 263-6845 | |
| (707) 263-6451 |
| Full Name | Lemuel C & Elmezen Martin |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 422 Lakeport Blvd, Lakeport, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477614741 | NPI | - | NPPES |
| ZZZ06870Z | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT11399 (California) | Primary |
| Provider Name | Lemuel C Martin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083622039 PECOS PAC ID: 4284731324 Enrollment ID: I20080327000339 |
| Mailing Address | Practice Location Address |
|---|---|
| Lemuel C & Elmezen Martin Po Box 1560, Lakeport, CA 95453-1560 Ph: (707) 263-6845 | Lemuel C & Elmezen Martin 422 Lakeport Blvd, Lakeport, CA 95453-5404 Ph: (707) 263-6845 |
Mr. Lemuel Campomanes Martin, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1281 Craig Avenue, Lakeport, CA 95453 Phone: 707-263-4564 Fax: 707-263-4572 | |
Aundrea Renee Tyner, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 381 Lakeport Blvd, Lakeport, CA 95453 Phone: 707-263-5210 | |
Matthew J. Garrean, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 1281 Craig Ave, Lakeport, CA 95453 Phone: 707-263-4564 Fax: 707-263-4572 | |
Clear Lake Physical Therapy Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1173 11th Street, Lakeport, CA 95453 Phone: 707-263-1295 Fax: 707-263-1295 | |
Lakeport Physical Therapy, Inc. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 381 Lakeport Blvd, Lakeport, CA 95453 Phone: 707-263-5210 Fax: 707-263-8045 |