Provider Demographics
NPI:1972004448
Name:MARTIN, JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CHARLESTON MILLS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-6063
Mailing Address - Country:US
Mailing Address - Phone:251-246-5761
Mailing Address - Fax:251-246-5665
Practice Address - Street 1:405 CHARLESTON MILLS DR
Practice Address - Street 2:
Practice Address - City:MIDLAND CITY
Practice Address - State:AL
Practice Address - Zip Code:36350-6063
Practice Address - Country:US
Practice Address - Phone:334-806-9371
Practice Address - Fax:334-625-6593
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist