Provider Demographics
NPI:1487048765
Name:MARTELL, ADRIANA LIZBETH (LAT, ATC)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:LIZBETH
Last Name:MARTELL
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:LIZBETH
Other - Last Name:OLIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:6036 W TURTLE HILL CT
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-6898
Mailing Address - Country:US
Mailing Address - Phone:765-242-0082
Mailing Address - Fax:
Practice Address - Street 1:6036 W TURTLE HILL CT
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IN
Practice Address - Zip Code:46041-6898
Practice Address - Country:US
Practice Address - Phone:765-242-0082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN36002963A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program