Provider Demographics
NPI:1598375545
Name:MARTZ, JENNA CATHERINE
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:CATHERINE
Last Name:MARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 AYSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7764
Mailing Address - Country:US
Mailing Address - Phone:410-443-1197
Mailing Address - Fax:
Practice Address - Street 1:4007 AYSHIRE CT
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7764
Practice Address - Country:US
Practice Address - Phone:410-443-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer