Individual
KATELYN ROSE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
251 MARKETPLACE DR # 1, FREEBURG, IL 62243-4082
(618) 539-0067
Mailing address
3708 ROUND HILL RD APT 11, SWANSEA, IL 62226-1221
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
06/30/2021
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