Individual
BRIAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
606 MAPLE VALLEY DR, FARMINGTON, MO 63640-1976
(573) 756-7779
(888) 849-3965
Mailing address
606 MAPLE VALLEY DR, FARMINGTON, MO 63640-1976
(573) 756-7779
(888) 849-3965
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
016005263
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2004019390
MO
Other
Enumeration date
04/24/2006
Last updated
12/04/2020
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