Provider Demographics
NPI:1053485110
Name:ROBERT J. MARTINEZ,D.C PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:ROBERT J. MARTINEZ,D.C PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-922-0484
Mailing Address - Street 1:912 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5331
Mailing Address - Country:US
Mailing Address - Phone:805-922-0484
Mailing Address - Fax:805-349-7232
Practice Address - Street 1:912 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5331
Practice Address - Country:US
Practice Address - Phone:805-922-0484
Practice Address - Fax:805-349-7232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty