Individual
TABATHA SUE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
804 INDUSTRIAL PARK RD, MAXWELTON, WV 24957-8066
(304) 497-0500
(304) 497-0516
Mailing address
804 INDUSTRIAL PARK RD, MAXWELTON, WV 24957-8066
(304) 497-0500
(304) 497-0516
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
32488
WV
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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