Provider Demographics
NPI:1740446780
Name:MARTINEZ, JANELLE M (DPT)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:M
Other - Last Name:RALPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 NATIONAL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1176
Mailing Address - Country:US
Mailing Address - Phone:240-678-8428
Mailing Address - Fax:
Practice Address - Street 1:3901 NATIONAL DR
Practice Address - Street 2:STE 100
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1176
Practice Address - Country:US
Practice Address - Phone:301-421-1125
Practice Address - Fax:301-500-2175
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist