Individual
CHARLES D MARTIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2568 S RIDGEWOOD AVE, STE 5, EDGEWATER, FL 32141-5980
(386) 427-8403
Mailing address
2568 S RIDGEWOOD AVE, STE 5, EDGEWATER, FL 32141-5980
(386) 427-8403
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH3303
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88572
BCBS
FL
01
—
AD239
MEDICARE GROUP ID
FL
Enumeration date
10/04/2006
Last updated
09/28/2007
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