Individual
DR. LARRY K MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 BANK STREET, STE 310, MISSOULA, MT 59802
(406) 549-7325
(406) 549-7559
Mailing address
125 BANK STREET, STE 310, MISSOULA, MT 59802
(406) 549-7325
(406) 549-7559
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MT5292
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53729
—
MT
01
—
92640
BLUE CROSS SHIELD
MT
Enumeration date
02/02/2007
Last updated
07/08/2007
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