Provider Demographics
NPI:1578002051
Name:MARTINEZ, CIRO MANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:CIRO
Middle Name:MANUEL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 RIVERDALE RD
Mailing Address - Street 2:211
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2150
Mailing Address - Country:US
Mailing Address - Phone:240-582-5779
Mailing Address - Fax:
Practice Address - Street 1:6201 RIVERDALE RD
Practice Address - Street 2:211
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2150
Practice Address - Country:US
Practice Address - Phone:240-582-5779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor