Provider Demographics
NPI:1952774663
Name:PLASTER, MARTHA (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:PLASTER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 SAM PECK RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-2159
Mailing Address - Country:US
Mailing Address - Phone:501-225-3601
Mailing Address - Fax:501-221-2897
Practice Address - Street 1:4610 SAM PECK RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-2159
Practice Address - Country:US
Practice Address - Phone:501-225-3601
Practice Address - Fax:501-221-2897
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist