Healthcare Provider Details

I. General information

NPI: 1225091077
Provider Name (Legal Business Name): ROBERT PATRICK MARTINI JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1243 SKYTOP MOUNTAIN RD SUITE1
PORT MATILDA PA
16870-7719
US

IV. Provider business mailing address

1243 SKYTOP MOUNTAIN RD SUITE1
PORT MATILDA PA
16870-7719
US

V. Phone/Fax

Practice location:
  • Phone: 814-238-6300
  • Fax: 814-238-0976
Mailing address:
  • Phone: 814-238-6300
  • Fax: 814-238-0976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005430L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: