Organization
CENTER FOR PRACTICAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA DEE MARTIN PA-C (OWNER/PROVIDER)
(907) 953-7949
Entity
Organization
Contact information
Practice address
102 E REDOUBT AVE, SOLDOTNA, AK 99669-8012
(907) 953-7949
Mailing address
102 E REDOUBT AVE, SOLDOTNA, AK 99669-8012
(907) 953-7949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1103
AK
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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