Provider Demographics
NPI:1295416436
Name:MARTINA'S PHYSICAL THERAPY . LLC
Entity type:Organization
Organization Name:MARTINA'S PHYSICAL THERAPY . LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:KONDAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:814-221-5390
Mailing Address - Street 1:847 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214
Mailing Address - Country:US
Mailing Address - Phone:814-221-5390
Mailing Address - Fax:814-393-6544
Practice Address - Street 1:847 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:CLARION, PA
Practice Address - State:PA
Practice Address - Zip Code:16214
Practice Address - Country:US
Practice Address - Phone:814-221-5390
Practice Address - Fax:814-393-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy