Provider Demographics
NPI:1629542980
Name:MARTINEZ CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MARTINEZ CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:318-547-6531
Mailing Address - Street 1:1828 TOWER DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-4938
Mailing Address - Country:US
Mailing Address - Phone:318-547-6531
Mailing Address - Fax:
Practice Address - Street 1:1828 TOWER DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-4938
Practice Address - Country:US
Practice Address - Phone:318-547-6531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty