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Individual
JIMMY JUSTIN MARTINDALE
Active
Individual
JIMMY JUSTIN MARTINDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, OCS, FAAOMPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1134740
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T4517
BCBS PROVIDER NUMBER
TX
Enumeration date
08/05/2006
Last updated
07/08/2007
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