Healthcare Provider Details

I. General information

NPI: 1497689533
Provider Name (Legal Business Name): JUAN EFREN MARTINEZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 DAYTON PIKE STE A
SODDY DAISY TN
37379-4202
US

IV. Provider business mailing address

8301 DAYTON PIKE STE A
SODDY DAISY TN
37379-4202
US

V. Phone/Fax

Practice location:
  • Phone: 423-842-2828
  • Fax:
Mailing address:
  • Phone: 423-842-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4058
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: