Provider Demographics
NPI:1811605538
Name:MARTINEZ, RALPH ESTEVAN JR (DC)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:ESTEVAN
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 WESTOVER PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-5529
Mailing Address - Country:US
Mailing Address - Phone:505-927-7025
Mailing Address - Fax:
Practice Address - Street 1:1920 WESTSIDE BLVD SE STE A
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4893
Practice Address - Country:US
Practice Address - Phone:505-922-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDC2297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor