MEDICARE: RALPH ESTEVAN MARTINEZ JR. DC

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	111N00000X	Chiropractor	DC2297	NM

General Provider Information

NPI Number	:	1811605538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RALPH ESTEVAN MARTINEZ JR. DC

Provider Business Mailing Address
First Line	:	8135 WESTOVER PL NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-5529
Country	:	US
Telephone Number	:	505-927-7025
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 WESTSIDE BLVD SE STE A
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87124-4893
Country	:	US
Telephone Number	:	505-922-9444
Fax Number	:

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

Provider Enumeration Date	:	11/10/2022
Last Update Date	:	11/10/2022

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