Provider Demographics
NPI:1306114715
Name:BARRE, MARTINE (DPT)
Entity type:Individual
Prefix:
First Name:MARTINE
Middle Name:
Last Name:BARRE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARTINE
Other - Middle Name:
Other - Last Name:ST.GERMAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6420 SEMINOLE TRL
Mailing Address - Street 2:L4
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22923-2836
Mailing Address - Country:US
Mailing Address - Phone:434-939-9524
Mailing Address - Fax:434-939-9679
Practice Address - Street 1:6420 SEMINOLE TRL
Practice Address - Street 2:L4
Practice Address - City:BARBOURSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22923-2836
Practice Address - Country:US
Practice Address - Phone:434-939-9524
Practice Address - Fax:434-939-9679
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6072225100000X
VA2305208770208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist