Provider Demographics
NPI:1730843640
Name:MARTIN PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MARTIN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:III
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:334-806-9371
Mailing Address - Street 1:405 CHARLESTON MILLS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-6063
Mailing Address - Country:US
Mailing Address - Phone:334-806-9371
Mailing Address - Fax:
Practice Address - Street 1:405 CHARLESTON MILLS DR
Practice Address - Street 2:
Practice Address - City:MIDLAND CITY
Practice Address - State:AL
Practice Address - Zip Code:36350-6063
Practice Address - Country:US
Practice Address - Phone:334-806-9371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy