Individual
LISA W MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/ CDE
Contact information
Practice address
2893 STURGIS RD, ROCK HILL, SC 29730-6607
(803) 366-9090
Mailing address
9600 MERSHAM CT, CHARLOTTE, NC 28269-8377
(704) 548-0404
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
651262
IL
Other
Enumeration date
07/15/2006
Last updated
07/08/2007
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