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General NPI Number Information
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NPI Number | 1750290896
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Entity Type | Individual
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Provider Name | RACHEL MARTIN PTA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 1720 W BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40203-3607
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Country | US
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Telephone | 601-596-6043
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 HOWELL RD APT K
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City | PURVIS
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State | MS
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Zip | 39475-3704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA6752
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License Number State | MS
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