Individual
MARTIN LOGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH
Contact information
Practice address
2316 5TH AVE, MOLINE, IL 61265-1530
(309) 762-5433
(309) 762-4481
Mailing address
2316 5TH AVE, MOLINE, IL 61265-1530
(309) 762-5433
(309) 762-4481
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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