Provider Demographics
NPI:1194896795
Name:MARTIN, CINDY A (PT, OCS)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 ENTERPRISE WAY NW STE 2
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4472
Mailing Address - Country:US
Mailing Address - Phone:256-713-1872
Mailing Address - Fax:256-713-1873
Practice Address - Street 1:1267 ENTERPRISE WAY NW STE 2
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4472
Practice Address - Country:US
Practice Address - Phone:256-713-1872
Practice Address - Fax:256-713-1873
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH2752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051522268OtherBCBS
AL511711170OtherBCBS
AL051512258OtherBCBS
ALCJ5487OtherRAILROAD MEDICARE
AL511711170OtherBCBS
AL051512258OtherBCBS