Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00268000 | NJ |
N | 111N00000X | Chiropractor | 813 | MA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 38MC00268000 | NJ |
NPI | 1669472353 |
---|---|
Provider Name | Dr. John Bartley Martinez |
First Address | Morristown, NJ 07960-7700 |
Second Address | Morristown, NJ 07960-7700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 14/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U17300 | (02) | NJ |