Individual
MRS. JO ANN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
292 CARLON LOOP RD, LONGVIEW, WA 98632-9674
(360) 425-0534
Mailing address
292 CARLON LOOP RD, LONGVIEW, WA 98632-9674
(360) 425-0534
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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