Provider Demographics
NPI:1902051782
Name:ARTOFF, MARTY LYNN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARTY
Middle Name:LYNN
Last Name:ARTOFF
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 WARDS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROGUE RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97537-4502
Mailing Address - Country:US
Mailing Address - Phone:541-941-7636
Mailing Address - Fax:541-582-0853
Practice Address - Street 1:2909 WARDS CREEK RD
Practice Address - Street 2:
Practice Address - City:ROGUE RIVER
Practice Address - State:OR
Practice Address - Zip Code:97537-4502
Practice Address - Country:US
Practice Address - Phone:541-941-7636
Practice Address - Fax:541-582-0853
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist