Individual
MR. DANIEL ROBERT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9688
Mailing address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9688
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2767
LA
133V00000X
Registered Dietitian
86065516
LA
Other
Enumeration date
05/12/2016
Last updated
08/24/2017
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