Martin, Amanda Maryellen

Martin, Amanda Maryellen is an individual health care provider with primary practice located at 521 E Elder St Suite 106, Fallbrook CA 92028-3081. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Martin, Amanda Maryellen can be contacted via phone (760) 723-8337.

Contact Information

Primary practice address
521 E Elder St Suite 106 Fallbrook CA 92028-3081
Phone: (760) 723-8337
Fax: (760) 723-5476
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT 38573 California

Profile Details

NPI number 1316210933
LBN Legal business name Martin, Amanda Maryellen
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2012
Last updated Mar 31st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316210933 NPPES
California Other 0PT385730 BLUE SHIELD PIN
California Other 12369967 BLUE SHIELD PIN

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