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Individual

MRS. STEPHANIE B MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
511 WASHINGTON, ELLIS, KS 67637
(785) 726-3644
Mailing address
511 WASHINGTON, ELLIS, KS 67637
(785) 726-3644

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00100947089
KS
Enumeration date
12/13/2006
Last updated
07/08/2007
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