Individual
RICHARD MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6149
(715) 858-4500
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1245
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42996400
—
WI
Enumeration date
08/27/2006
Last updated
09/11/2009
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