Provider Demographics
NPI:1679022537
Name:MARTINEZ, MONICA
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:MARTINEZ
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 1:1009 AYERSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-3104
Mailing Address - Country:US
Mailing Address - Phone:419-782-3662
Mailing Address - Fax:419-782-3662
Practice Address - Street 1:1009 AYERSVILLE AVE
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-3104
Practice Address - Country:US
Practice Address - Phone:419-782-3662
Practice Address - Fax:419-782-3662
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health