Provider Demographics
NPI:1619992898
Name:MARTIN, JOY (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 W WALNUT AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6233
Mailing Address - Country:US
Mailing Address - Phone:559-636-1200
Mailing Address - Fax:
Practice Address - Street 1:1730 W WALNUT AVE
Practice Address - Street 2:STE. B
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6233
Practice Address - Country:US
Practice Address - Phone:559-636-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ20976ZMedicare ID - Type Unspecified