Individual
MR. SPENCER DALTON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
213 WESTFIELD DR, RICHLANDS, NC 28574-8009
(850) 200-2251
Mailing address
FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-0001
(619) 532-7968
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/19/2022
Last updated
01/03/2024
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