Provider Demographics
NPI:1083847982
Name:MARTINI CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:MARTINI CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-421-1340
Mailing Address - Street 1:1000 WHITLOCK AVE NW
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5455
Mailing Address - Country:US
Mailing Address - Phone:770-421-1340
Mailing Address - Fax:770-421-0096
Practice Address - Street 1:1000 WHITLOCK AVE NW
Practice Address - Street 2:SUITE 340
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5455
Practice Address - Country:US
Practice Address - Phone:770-421-1340
Practice Address - Fax:770-421-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========Medicare PIN