Individual
THOMAS MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
20370 POE SHOLES DR, BEND, OR 97703-7938
(541) 318-1377
(541) 383-4587
Mailing address
20370 POE SHOLES DR, BEND, OR 97703-7938
(541) 318-1377
(541) 383-4587
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201400886RN
OR
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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