Individual
MATTHEW ELLIS MARTING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
12006 MANCHESTER ROAD, ST LOUIS, MO 63131
(314) 965-0030
Mailing address
12006 MANCHESTER ROAD, ST LOUIS, MO 63131
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2012042657
MO
Other
Enumeration date
02/15/2021
Last updated
02/15/2021
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