Provider Demographics
NPI:1043794258
Name:MARTIN, HUNTER LEIGH
Entity Type:Individual
Prefix:MISS
First Name:HUNTER
Middle Name:LEIGH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SAINT CROIX DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-8605
Mailing Address - Country:US
Mailing Address - Phone:478-952-3464
Mailing Address - Fax:
Practice Address - Street 1:127 SAINT CROIX DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8605
Practice Address - Country:US
Practice Address - Phone:478-952-3464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer