Provider Demographics
NPI:1467081117
Name:MARTIN, ALEXANDRA KAYE (DAT, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:KAYE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DAT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2996 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4940
Mailing Address - Country:US
Mailing Address - Phone:440-759-5251
Mailing Address - Fax:
Practice Address - Street 1:2996 MEADOW LN
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4940
Practice Address - Country:US
Practice Address - Phone:440-759-5251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-05
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0063662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer