Provider Demographics
NPI:1184055733
Name:MARTIN, ERIN (MS, PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5233 POTOMAC LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-8811
Mailing Address - Country:US
Mailing Address - Phone:317-508-9028
Mailing Address - Fax:
Practice Address - Street 1:9325 N CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:KNIGHTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47857
Practice Address - Country:US
Practice Address - Phone:812-446-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004870A174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator