Individual
MARTEL L PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5401 TACONY ST BLDG 38K3, PHILADELPHIA, PA 19137
(445) 207-6002
Mailing address
5401 TACONY ST BLDG 38K3, PHILADELPHIA, PA 19137
(445) 207-6002
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
Other
Enumeration date
06/19/2025
Last updated
06/19/2025
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