Provider Demographics
NPI:1326679200
Name:MARTIN, HUNTER ALEXANDRIA (BT)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:ALEXANDRIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 UNION RD APT L
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0501
Mailing Address - Country:US
Mailing Address - Phone:704-530-8005
Mailing Address - Fax:
Practice Address - Street 1:1236 UNION RD APT L
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0501
Practice Address - Country:US
Practice Address - Phone:704-530-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty