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Individual

JUAN MARTINEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1259 LAKE PLAZA DR, COLORADO SPRINGS, CO 80906-3504
(719) 333-5804
Mailing address
5901 WHISKEY RIVER DR, COLORADO SPRINGS, CO 80923-4105
(719) 432-9456

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0174955
CO
363LG0600X
Gerontology Nurse Practitioner
Primary
0174955
CO

Other

Enumeration date
03/18/2015
Last updated
04/24/2024
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