Individual
DR. MARY MARTHA FUTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
31 S 6TH ST, MACCLENNY, FL 32063-2311
(904) 259-6259
(904) 259-3436
Mailing address
9863 OLD PLANK RD, JACKSONVILLE, FL 32220-1335
(904) 783-8613
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2517
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620401500
—
FL
Enumeration date
07/20/2006
Last updated
07/08/2007
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