Individual
MS. DODIE LANE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 LOCUST ST, LA CROSSE, KS 67548-9673
(785) 222-2564
(785) 222-2868
Mailing address
PO BOX 520, LA CROSSE, KS 67548-0520
(785) 222-2564
(785) 222-2868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01190
KS
Other
Enumeration date
10/31/2007
Last updated
12/18/2019
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