Individual
BROOKE ELLYN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, LAT, ATC
Contact information
Practice address
13307 BOOKER T WASHINGTON HWY, HARDY, VA 24101-3945
(540) 721-4199
Mailing address
245 STEEPLECHASE LN, BOONES MILL, VA 24065
(540) 266-4037
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305214275
VA
2255A2300X
Athletic Trainer
0126002993
VA
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2017
Last updated
12/10/2024
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