Provider Demographics
NPI:1730831702
Name:MARTIN, AMBER LYNN (MSAT, LAT, ATC, CES)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MSAT, LAT, ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PRESTON DR
Mailing Address - Street 2:
Mailing Address - City:HUDDLESTON
Mailing Address - State:VA
Mailing Address - Zip Code:24104-3007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:365 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173-0001
Practice Address - Country:US
Practice Address - Phone:804-289-8759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260037862255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer