Provider Demographics
NPI:1114134855
Name:MARTENSSON, LEIF ARTUR (DC)
Entity Type:Individual
Prefix:DR
First Name:LEIF
Middle Name:ARTUR
Last Name:MARTENSSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 GULF LAND DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4844
Mailing Address - Country:US
Mailing Address - Phone:407-358-9526
Mailing Address - Fax:
Practice Address - Street 1:3577 LAKE EMMA RD
Practice Address - Street 2:SUITE 121
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2056
Practice Address - Country:US
Practice Address - Phone:407-333-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor