Provider Demographics
NPI:1699989129
Name:MARTELLO CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MARTELLO CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRST MANAGER MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NED
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-754-7777
Mailing Address - Street 1:1962 ONEAL LN
Mailing Address - Street 2:STE I
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3250
Mailing Address - Country:US
Mailing Address - Phone:225-754-7777
Mailing Address - Fax:225-751-7795
Practice Address - Street 1:1962 ONEAL LN
Practice Address - Street 2:STE I
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3250
Practice Address - Country:US
Practice Address - Phone:225-754-7777
Practice Address - Fax:225-751-7795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty