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General NPI Number Information
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NPI Number | 1205354594
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Entity Type | Individual
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Provider Name | NATALIE MARIE MARTOS ATC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 14400 N TATUM BLVD
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City | PHOENIX
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State | AZ
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Zip | 85032-5531
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Country | US
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Telephone | 602-992-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 13867 N 159TH DR
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City | SURPRISE
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State | AZ
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Zip | 85379-5005
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Country | US
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Telephone | 480-495-3202
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1654
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License Number State | AZ
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