Individual
MR. JONATHAN TAYLOR MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAE
Contact information
Practice address
812 THOMAS AVE, DAVIS, WV 26260-0694
(304) 694-5226
Mailing address
PO BOX 694, DAVIS, WV 26260-0694
(304) 694-5226
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
WV
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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