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Individual

SANTACHIA RENEE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
(336) 655-0560
(847) 574-0765
Mailing address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
(336) 655-0560
(847) 574-0765

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
118096971
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
91AE3
DLA CAGE CODE SAMS.GOV
NC
Enumeration date
06/01/2021
Last updated
06/01/2021
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