Individual
JENNIFER A MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT, OCS, FAAOMPT
Contact information
Practice address
1295 WESTHAVEN DR, VAIL, CO 81657-4395
(970) 476-7510
Mailing address
570 HOMESTEAD DR APT 38, EDWARDS, CO 81632-8162
(612) 339-2041
(970) 476-7511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5264
MN
2251X0800X
Orthopedic Physical Therapist
Primary
0004838
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060T1MA
BC INDIV PROV ID
MN
05
—
076649600
—
MN
01
—
6402269
MEDICA INDIV PROV ID
MN
Enumeration date
04/14/2006
Last updated
04/13/2020
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