Individual
IVARILLA JEMISE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 N INDIAN CANYON DR, SUITE A, PALM SPRINGS, CA 92262-4880
(760) 322-9065
Mailing address
1330 N INDIAN CANYON DR, SUITE A, PALM SPRINGS, CA 92262-4880
(760) 322-9065
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
257724
CA
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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