Provider Demographics
NPI:1669889226
Name:MARTINS, JENNIFER KAY (PT, DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:MARTINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KAY
Other - Last Name:CHAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2567 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9561
Mailing Address - Country:US
Mailing Address - Phone:330-558-0100
Mailing Address - Fax:330-558-0110
Practice Address - Street 1:2567 CENTER RD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233-9561
Practice Address - Country:US
Practice Address - Phone:330-558-0100
Practice Address - Fax:330-558-0110
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH014918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist