Provider Demographics
NPI:1992969836
Name:MARTEL, BRENDA L
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:MARTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:L
Other - Last Name:MARTEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:3 DUNKLEE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2851
Mailing Address - Country:US
Mailing Address - Phone:603-225-6282
Mailing Address - Fax:
Practice Address - Street 1:1276 HANOVER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5623
Practice Address - Country:US
Practice Address - Phone:603-622-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH365225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant