Provider Demographics
NPI:1851980908
Name:MARTIN, DARREN MICHAEL (LPTA)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:MICHAEL
Last Name:MARTIN
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2789 CATTAIL RD APT 6
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9550
Mailing Address - Country:US
Mailing Address - Phone:740-352-1488
Mailing Address - Fax:740-876-4650
Practice Address - Street 1:381 CAMP ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN FURNACE
Practice Address - State:OH
Practice Address - Zip Code:45629-7503
Practice Address - Country:US
Practice Address - Phone:740-574-1315
Practice Address - Fax:740-876-4650
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA011435225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant