Individual
MRS. SPANTAMMIE D MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4405 HIGHWAY 24, ANDERSON, SC 29626-5216
(864) 226-7776
Mailing address
PO BOX 236, IVA, SC 29655-0236
(864) 844-1659
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9799
SC
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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