Healthcare Provider Details

I. General information

NPI: 1275727885
Provider Name (Legal Business Name): RHONDA JANE MARTIN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W RUN RD
MUNHALL PA
15120-2869
US

IV. Provider business mailing address

3411 CYPRESS ST
WEST MIFFLIN PA
15122-1528
US

V. Phone/Fax

Practice location:
  • Phone: 412-462-8002
  • Fax: 412-462-2113
Mailing address:
  • Phone: 412-464-9624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE001891L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: