Provider Demographics
NPI:1700819711
Name:MARTINEK PHYSICAL THERAPY, P.L.C.
Entity Type:Organization
Organization Name:MARTINEK PHYSICAL THERAPY, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:MARTINEK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:641-231-1263
Mailing Address - Street 1:20 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-1712
Mailing Address - Country:US
Mailing Address - Phone:641-357-0165
Mailing Address - Fax:641-357-0166
Practice Address - Street 1:20 N 8TH ST
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-1712
Practice Address - Country:US
Practice Address - Phone:641-357-0165
Practice Address - Fax:641-357-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty