Provider Demographics
NPI:1568234417
Name:MARTINEZ, DANIEL FRED JR (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:FRED
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 MARMOT RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-8425
Mailing Address - Country:US
Mailing Address - Phone:720-427-3181
Mailing Address - Fax:
Practice Address - Street 1:7227 S SIMMS ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3245
Practice Address - Country:US
Practice Address - Phone:303-982-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00006802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer