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General NPI Number Information
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NPI Number | 1710390711
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Entity Type | Individual
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Provider Name | JENNA MARTINI D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 4 CLEMENT WAY
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City | BELGRADE
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State | ME
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Zip | 04917-4370
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Country | US
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Telephone | 207-495-3323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 727
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City | WATERVILLE
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State | ME
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Zip | 04903-0727
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Country | US
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Telephone | 207-495-3323
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Fax | 707-826-8638
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | DO3445
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO3445
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License Number State | ME
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