Individual
LARA J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
735 EAST MAIN ST, SPARTANBURG, SC 29302-1281
(864) 542-1308
Mailing address
139 SHELTON DR, SPARTANBURG, SC 29307-2555
(864) 542-1308
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1371
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D13714
—
SC
Enumeration date
08/25/2006
Last updated
10/25/2007
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