Provider Demographics
NPI:1699858977
Name:MARTIN, JOSEPH L III (MPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:MARTIN
Suffix:III
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:906 SOUTH FEDERAL HWY STE B
Mailing Address - Street 2:MARTIN PHYSICAL THERAPY PA
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-738-0805
Mailing Address - Fax:561-738-0815
Practice Address - Street 1:906 SOUTH FEDERAL HWY STE B
Practice Address - Street 2:MARTIN PHYSICAL THERAPY PA
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-738-0805
Practice Address - Fax:561-738-0815
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT14841225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9055ZMedicare UPIN
FLY9055ZMedicare PIN