Provider Demographics
NPI:1336469303
Name:GREER, MARTI (MS, ATC, RT(R))
Entity Type:Individual
Prefix:
First Name:MARTI
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:MS, ATC, RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 EAGLES PEAK WAY
Mailing Address - Street 2:202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1394
Mailing Address - Country:US
Mailing Address - Phone:859-539-2886
Mailing Address - Fax:
Practice Address - Street 1:1227 GOSS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1239
Practice Address - Country:US
Practice Address - Phone:859-539-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT7802255A2300X
FLCRT548832471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography