Provider Demographics
NPI:1164667382
Name:MARTONE, HOLLY (DC)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:MARTONE
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 1:5801 TRAFFIC WAY
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422
Mailing Address - Country:US
Mailing Address - Phone:805-466-3643
Mailing Address - Fax:805-466-3296
Practice Address - Street 1:5801 TRAFFIC WAY
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422
Practice Address - Country:US
Practice Address - Phone:805-466-3643
Practice Address - Fax:805-466-3296
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor