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NPI Code Detail

MEDICARE: CHALICE J MARTINEZ OT

MEDICARE: CHALICE J MARTINEZ OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1682AR

General Provider Information

NPI Number : 1487944047
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHALICE J MARTINEZ OT
Provider Business Mailing Address
First Line : 311 LEXINGTON AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-3842
Country : US
Telephone Number : 479-649-3983
Fax Number :
Provider Business Practice Location Address
First Line : 311 LEXINGTON AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-3842
Country : US
Telephone Number : 479-782-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2011
Last Update Date : 03/05/2025

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Directions to “ CHALICE J MARTINEZ OT” Practice Location

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