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Individual

SONJA RENEE COLLIER MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099-8199
(501) 987-7319
Mailing address
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099-4933
(501) 987-7319

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-410
AR
363A00000X
Physician Assistant
PA9102973
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00390663
RAILROAD MEDICARE
FL
Enumeration date
07/25/2006
Last updated
08/12/2020
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