Individual
THOR MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
6171 W CHARLESTON BLVD BLDG 11W, LAS VEGAS, NV 89146-1126
(702) 486-0464
(702) 486-7656
Mailing address
6661 SILVERSTREAM AVE APT 2072, LAS VEGAS, NV 89107-1173
(702) 486-0464
(702) 486-7656
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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