Provider Demographics
NPI:1184198350
Name:MARTIN, JANET P (PT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:P
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:P
Other - Last Name:PRATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:2777 BIG SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:PAMPLICO
Mailing Address - State:SC
Mailing Address - Zip Code:29583-5222
Mailing Address - Country:US
Mailing Address - Phone:843-601-0232
Mailing Address - Fax:
Practice Address - Street 1:401 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HEMINGWAY
Practice Address - State:SC
Practice Address - Zip Code:29554-9106
Practice Address - Country:US
Practice Address - Phone:843-558-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist