Provider Demographics
NPI:1275099962
Name:MARTIN, BRITTANY (RKT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RKT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 LLOYD LN
Mailing Address - Street 2:
Mailing Address - City:CITRONELLE
Mailing Address - State:AL
Mailing Address - Zip Code:36522-2605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30941 MILL LN STE G-318
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5456
Practice Address - Country:US
Practice Address - Phone:256-393-7501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2003226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist