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Individual

MRS. MARTIKA SHONTA SWAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.,

Contact information

Practice address
5850 US HIGHWAY 431 # A, ALBERTVILLE, AL 35950-2048
(256) 878-0125
(256) 878-0939
Mailing address
PO BOX 207243, DALLAS, TX 75320-7243
(636) 200-4393
(636) 527-0766

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-D58-TA-A54
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
219023
AL
05
219541
AL
Enumeration date
06/06/2016
Last updated
09/20/2021
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