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General NPI Number Information
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NPI Number | 1386602589
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Entity Type | Individual
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Provider Name | JOHN ALBERT MARTY JR. DPM
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 186 BLANEY RD SUITE A
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City | KITTANNING
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State | PA
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Zip | 16201-3568
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Country | US
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Telephone | 724-543-3668
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Fax | 724-543-2087
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Provider Business Mailing Address
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Address Line | 186 BLANEY RD SUITE A
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City | KITTANNING
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State | PA
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Zip | 16201-3568
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Country | US
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Telephone | 724-543-3668
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Fax | 724-543-2087
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC002620-L
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License Number State | PA
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