Individual
MS. MARY C. MARTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
184 S TIFFANY DR, STE 108, PUEBLO WEST, CO 81007-3583
(719) 671-6674
(719) 647-0262
Mailing address
184 S TIFFANY DR, STE 108, PUEBLO WEST, CO 81007-3583
(719) 671-6674
(719) 647-0262
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
16
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07686405
—
CO
Enumeration date
09/20/2006
Last updated
02/08/2011
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