Doctor Name: | PAMELA A MARTIN |
NPI Number: | 1154380293 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT ATC |
License Number: | PT1850 |
Business Practice Address: | 1618 Millenium Way Suite 210 Meridian, ID - 836426439 |
Business Phone Number: | 2088844647 |
Business Fax Number: | 2088848984 |
Mailing Address: | 1673 W Shoreline Dr, Suite 230 BOISE |
State: | ID |
Postal Code: | 837026750 |
Phone Number: | 2083434700 |
Fax Number: | 2083434706 |
NPI Enumeration Date: | 03/18/2006 |
NPI Last Update Date: | 06/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT1850 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |