Individual
MR. MARTIN LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 BRANCHPORT DR, CHESTERFIELD, MO 63017-2902
(314) 469-3484
(314) 469-3484
Mailing address
330 BRANCHPORT DR, CHESTERFIELD, MO 63017-2902
(314) 469-3484
(314) 469-3484
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/22/2008
Last updated
07/21/2022
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