Provider Demographics
NPI:1467815795
Name:CAINE, MARTIN ALLEN (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:ALLEN
Last Name:CAINE
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 SPITZ DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-2342
Mailing Address - Country:US
Mailing Address - Phone:405-388-2921
Mailing Address - Fax:
Practice Address - Street 1:1 JETS DR
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1215
Practice Address - Country:US
Practice Address - Phone:405-388-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2005022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer