Martin, Jessica Athena
Martin, Jessica Athena is an individual health care provider with primary practice located at 1011 Frontage Rd , Greenville SC 29615-4240. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, which is considered as her primary health care specialty. Martin, Jessica Athena can be contacted via phone (864) 242-4263.Contact Information
Primary practice address
1011 Frontage Rd
Greenville SC 29615-4240
Phone: (864) 242-4263
Fax: (864) 242-2250
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand | 225XH1200X | 4381 | South Carolina |
Profile Details
NPI number | 1053033605 |
---|---|
LBN Legal business name | Martin, Jessica Athena |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 12th, 2022 |
Last updated | Oct 6th, 2022 - about 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053033605 | NPPES |
South Carolina | MEDICAID | PENDING |
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