Individual
TINA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
7668 FM 2022, GRAPELAND, TX 75844-4348
(936) 687-3718
Mailing address
7668 FM 2022, GRAPELAND, TX 75844-4348
(936) 687-3718
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
189317
TX
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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