Individual
MR. CHARLES MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
1619 5TH AVE, TERRE HAUTE, IN 47807
(219) 902-1019
Mailing address
1619 5TH AVE, TERRE HAUTE, IN 47807-1207
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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