Individual
EDWARD JUSTIN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
775 POLE LINE RD W STE 301, TWIN FALLS, ID 83301-5823
(208) 814-8700
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(120) 838-1877
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
279546
MA
208800000X
Urology Physician
Primary
M-16287
ID
Other
Enumeration date
04/17/2014
Last updated
04/25/2022
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