Provider Demographics
NPI:1699817130
Name:MARTENSEN, JAN (DC, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:
Last Name:MARTENSEN
Suffix:
Gender:M
Credentials:DC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CENTER ST
Mailing Address - Street 2:#214
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4324
Mailing Address - Country:US
Mailing Address - Phone:866-234-4376
Mailing Address - Fax:678-279-9944
Practice Address - Street 1:29 MILL ST
Practice Address - Street 2:UNIT C4
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4328
Practice Address - Country:US
Practice Address - Phone:603-569-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1364111NR0200X
GACHIR009086111NR0200X
NH960111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology