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Individual

JEREMIAS MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1212 S 58TH CT, CICERO, IL 60804-1116
(708) 646-8684
Mailing address
1212 S 58TH CT, CICERO, IL 60804-1116
(708) 646-8684

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
M635-4349-1262
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
M635-4349-1262
IL

Other

Enumeration date
09/11/2016
Last updated
09/11/2016
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