Individual
SAMMY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
164W00000X
Contact information
Practice address
9040 JACKSON AVENUE, JBLM, WA 98431
(253) 968-0758
Mailing address
9040 JACKSON AVENUE, MADIGAN ARMY MEDICAL CENTER,, JBLM, WA 98431
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
317949
TX
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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