Provider Demographics
NPI:1386190999
Name:MARTIN, JOSA JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:JOSA
Middle Name:JAMES
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 3RD AVENUE
Mailing Address - Street 2:ST CLOUD HOSPITAL PHYSICAL THERAPY ALBANY
Mailing Address - City:ALBANY
Mailing Address - State:MN
Mailing Address - Zip Code:56307-5120
Mailing Address - Country:US
Mailing Address - Phone:320-845-2157
Mailing Address - Fax:320-845-6138
Practice Address - Street 1:109 COURT AVENUE SOUTH
Practice Address - Street 2:ESSENTIA HEALTH SANDSTONE
Practice Address - City:SANDSTONE
Practice Address - State:MN
Practice Address - Zip Code:55072-5120
Practice Address - Country:US
Practice Address - Phone:320-245-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist