Individual
CHRISTINA CLARK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.N.
Contact information
Practice address
146 W OAK ST, PONCHATOULA, LA 70454-3329
(318) 614-9516
Mailing address
PO BOX 2102, PONCHATOULA, LA 70454-2102
(318) 614-9516
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2548
LA
Other
Enumeration date
11/24/2014
Last updated
10/12/2022
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