Provider Demographics
NPI:1538448014
Name:MARTINEZ, RACHELLE AILEEN (LMT)
Entity type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:AILEEN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:RACHELLE
Other - Middle Name:AILEEN
Other - Last Name:AVALOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1171 S SABLE BLVD UNIT E
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4900
Mailing Address - Country:US
Mailing Address - Phone:720-829-3833
Mailing Address - Fax:
Practice Address - Street 1:2323 S TROY ST STE 108
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1946
Practice Address - Country:US
Practice Address - Phone:720-829-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
CO0019676225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant