Individual
RAITHEL JEAN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSE, LAT, ATC
Contact information
Practice address
405 NW 3RD ST, ANDREWS, TX 79714-5014
(432) 523-3640
Mailing address
6610 N LOVINGTON HWY, HOBBS, NM 88240-9120
(210) 213-0147
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7439
TX
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000030454
BOC NATIONAL CERTIFICATION
—
01
—
AT7439
TEXAS STATE AT LICENSE
TX
Enumeration date
11/07/2017
Last updated
08/26/2022
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