Provider Demographics
NPI:1184016925
Name:MARTIN, KAYLA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:WHIPPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4 RAIN TREE CT
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3209
Mailing Address - Country:US
Mailing Address - Phone:973-617-0321
Mailing Address - Fax:
Practice Address - Street 1:120 E LANCASTER AVE STE 205
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-3209
Practice Address - Country:US
Practice Address - Phone:484-297-6491
Practice Address - Fax:610-896-7218
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251X0800X
NJ40QA01600900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist