Healthcare Provider Details

I. General information

NPI: 1578041224
Provider Name (Legal Business Name): CHELSEA K MARTINEZ PT, DPT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2018
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W POPLAR ST
ROGERS AR
72756-4242
US

IV. Provider business mailing address

500 SW DIAMOND DR APT 10
BENTONVILLE AR
72712-7396
US

V. Phone/Fax

Practice location:
  • Phone: 479-631-7678
  • Fax:
Mailing address:
  • Phone: 325-387-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number5300
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5263
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: