Individual provider · NPI-1

Reynaldo Martinez

Prosthetic/Orthotic Supplier · Johnson City, TN

NPI number1851580955

StatusActive

Last updated in NPPESMay 19, 2008

Details

NPI: 1851580955
Entity type: Individual (NPI-1)
Name: Mr. Reynaldo Martinez
Sex: Male
Sole proprietor: Yes
Enumeration date: Oct 15, 2007
Last updated: May 19, 2008

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
335E00000X	Prosthetic/Orthotic Supplier	–	–	Yes
332B00000X	Durable Medical Equipment & Medical Supplies	–	–

Practice location

3201 Bristol Hwy
Suite 4
Johnson City, TN 37601-1565

Phone 423-262-8327 · Fax 423-262-8329

Mailing address

Po Box 8816
Gray, TN 37615-0816

Phone 423-262-8327 · Fax 423-262-8329

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