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NPI Code Detail

MEDICARE: MRS. JENNIFER MARTIN PT

MEDICARE: MRS. JENNIFER MARTIN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist004596KY

General Provider Information

NPI Number : 1598793986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER MARTIN PT
Provider Business Mailing Address
First Line : 1410 LONG RUN RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40245-4334
Country : US
Telephone Number : 502-244-8011
Fax Number : 502-244-6631
Provider Business Practice Location Address
First Line : 1410 LONG RUN RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40245-4334
Country : US
Telephone Number : 502-244-8011
Fax Number : 502-244-6631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. JENNIFER MARTIN PT” Practice Location

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