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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 3 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 1053033605 NPPES
South Carolina MEDICAID PENDING

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