Healthcare Provider Details

I. General information

NPI: 1669875159
Provider Name (Legal Business Name): TONIA MARTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 09/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 GEORGETOWN ST
LOUISVILLE OH
44641-9672
US

IV. Provider business mailing address

828 S UNION AVE APT B
ALLIANCE OH
44601-2935
US

V. Phone/Fax

Practice location:
  • Phone: 330-284-6463
  • Fax:
Mailing address:
  • Phone: 330-284-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number350789
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: