Provider Demographics
NPI:1043002066
Name:OSTEOPATHIC MEDICINE OF MAINE PLLC
Entity type:Organization
Organization Name:OSTEOPATHIC MEDICINE OF MAINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-392-5677
Mailing Address - Street 1:496 FARMINGTON FALLS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6438
Mailing Address - Country:US
Mailing Address - Phone:207-212-1449
Mailing Address - Fax:
Practice Address - Street 1:496 FARMINGTON FALLS RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6438
Practice Address - Country:US
Practice Address - Phone:207-212-1449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty