Individual
LISA M MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 N, WV-2, NEW MARTINSVILLE, WV 26155
(204) 455-5515
Mailing address
PO BOX 716, NEW MARTINSVILLE, WV 26155-0716
(304) 455-5515
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5199661
FL
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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