Provider Demographics
NPI:1831218403
Name:GARLICK, MARTHA JOAN (PT, DPT, MS, CCS)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:JOAN
Last Name:GARLICK
Suffix:
Gender:F
Credentials:PT, DPT, MS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 FOSKETT ST
Mailing Address - Street 2:1
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2108
Mailing Address - Country:US
Mailing Address - Phone:617-764-2704
Mailing Address - Fax:617-726-8012
Practice Address - Street 1:32 FOSKETT ST
Practice Address - Street 2:1
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2108
Practice Address - Country:US
Practice Address - Phone:617-764-2704
Practice Address - Fax:617-726-8012
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA65662251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary