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Individual

CODY V MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
189 AIRPORT WAY, UNALAKLEET, AK 99684
(907) 624-3535
(907) 624-3692
Mailing address
189 AIRPORT WAY, UNALAKLEET, AK 99684
(907) 624-3535
(907) 624-3692

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CHA II
CHA II
AK
Enumeration date
11/26/2014
Last updated
11/26/2014
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