MEDICARE: ANGELO MARTINEZ LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	33.023902	OH

General Provider Information

NPI Number	:	1770244881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELO MARTINEZ LMT

Provider Business Mailing Address
First Line	:	53 6TH ST
Second Line	:
City	:	CAMPBELL
State	:	OH
Zip	:	44405-1351
Country	:	US
Telephone Number	:	330-720-3461
Fax Number	:

Provider Business Practice Location Address
First Line	:	1206 E MARKET ST
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-6606
Country	:	US
Telephone Number	:	330-394-7246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2022
Last Update Date	:	01/02/2022

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Directions to “ ANGELO MARTINEZ LMT” Practice Location

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