Individual
MR. CHARLES STEWART MARTIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN, MBA
Contact information
Practice address
759 SUSQUEHANNA TRL, WATSONTOWN, PA 17777-8109
(570) 538-1240
(570) 538-1257
Mailing address
759 SUSQUEHANNA TRL, WATSONTOWN, PA 17777-8109
(570) 538-1240
(570) 538-1257
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN265059
PA
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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