Provider Demographics
NPI:1588004824
Name:MARTINEZ, JASON D (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:D
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:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-1237
Mailing Address - Country:US
Mailing Address - Phone:901-367-0811
Mailing Address - Fax:901-367-9569
Practice Address - Street 1:5570 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3805
Practice Address - Country:US
Practice Address - Phone:901-367-0811
Practice Address - Fax:901-367-9569
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor