Provider Demographics
NPI:1215726419
Name:MARTIN, NOAH JAMES (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:JAMES
Last Name:MARTIN
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 LANSING DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-6236
Mailing Address - Country:US
Mailing Address - Phone:319-538-7792
Mailing Address - Fax:
Practice Address - Street 1:2854 CORAL CT # 1
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2809
Practice Address - Country:US
Practice Address - Phone:319-259-6224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA131121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist