Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI Number | 1295985992 |
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| LBN Legal business name | MARTIN FAMILY HEALTHCARE LLC. | ||||
| Authorized official | ANDREA MARTIN - (PHYSICIAN ASST./OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 09/30/2008 | ||||
| Last updated | 10/07/2009 - About 17 years ago | ||||
| Identifiers |
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