Individual
MARTINE THELUSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
978 GRAY DR, PICKERINGTON, OH 43147-9358
(954) 655-6275
Mailing address
978 GRAY DR, PICKERINGTON, OH 43147-9358
(954) 655-6275
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
VK695545
OH
172A00000X
Driver
—
—
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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