Individual
DR. AMANDA R MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 COLLEY AVE, NORFOLK, VA 23517-1613
(757) 622-5595
(757) 622-2517
Mailing address
1900 COLLEY AVE, NORFOLK, VA 23517-1613
(757) 622-5595
(757) 622-2517
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
0618001509
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018425P76
MEDICARE PTAN
VA
Enumeration date
06/01/2006
Last updated
10/13/2011
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