Individual
DAVID ANDREW MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15310 CR T.37, LA JARA, CO 81140
(719) 580-6947
Mailing address
PO BOX 207, LA JARA, CO 81140-0207
(719) 580-6947
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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