Provider Demographics
NPI:1851688550
Name:MARTIN, ANDREA E (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 FAIRFAX DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1772
Mailing Address - Country:US
Mailing Address - Phone:703-717-6900
Mailing Address - Fax:703-717-6909
Practice Address - Street 1:3833 FAIRFAX DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1772
Practice Address - Country:US
Practice Address - Phone:703-717-6900
Practice Address - Fax:703-717-6909
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305206979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist