Individual
NICHOLAS J. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001084
WV
225100000X
Physical Therapist
PT006744L
PA
225100000X
Physical Therapist
PT007091
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000745333
BLUE CROSS/BLUE SHIELD
—
05
—
0156604000
—
WV
01
—
1515473000
US DEPT OF LABOR
WV
01
—
55071930000
WV WORKERS COMP BRICKSTEE
WV
01
—
55071930003
THE HEALTH PLAN BWC
WV
Enumeration date
08/11/2006
Last updated
04/01/2024
Update your record
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