Healthcare Provider Details

I. General information

NPI: 1730132671
Provider Name (Legal Business Name): ROBERT P. MARTINI JR, D.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/22/2020
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: DR. ROBERT P MARTINI JR.
Title or Position: OWNER
Credential: D.O.
Phone: 814-238-6300