Individual
JESSICA ATHENA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 FRONTAGE RD, GREENVILLE, SC 29615-4240
(864) 242-4263
(864) 242-2250
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
4381
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
09/12/2022
Last updated
10/06/2022
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