Provider Demographics
NPI:1225829773
Name:FISHER, MARTINA DAWNLEE (LMT)
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:DAWNLEE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:MARTINA
Other - Middle Name:DAWNLEE
Other - Last Name:HAGERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1200 BATTLEFIELD BLVD N STE 120
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4790
Mailing Address - Country:US
Mailing Address - Phone:757-582-1190
Mailing Address - Fax:
Practice Address - Street 1:1200 BATTLEFIELD BLVD N STE 120
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4790
Practice Address - Country:US
Practice Address - Phone:757-277-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019007867225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist