Individual
JENNIFER L MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 HOSPITAL DR, MARTINSVILLE, VA 24112-1900
(972) 989-3320
Mailing address
11 SAINT CHRISTOPHER SQ, GREENSBORO, NC 27410-9757
(972) 989-3320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007514
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/08/2019
Last updated
07/03/2021
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