Provider Demographics
NPI:1699027771
Name:MARTIN, ABIGAIL ANN (PTA)
Entity Type:Individual
Prefix:MISS
First Name:ABIGAIL
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2602
Mailing Address - Country:US
Mailing Address - Phone:724-430-1128
Mailing Address - Fax:724-430-2438
Practice Address - Street 1:520 W MAIN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2602
Practice Address - Country:US
Practice Address - Phone:724-430-1128
Practice Address - Fax:724-430-2438
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI001235225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant