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Individual

JODI LYNN MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
(574) 272-9290
Mailing address
1845 ALTGELD ST, SOUTH BEND, IN 46614-1603
(317) 512-6929

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27058896A
IN

Other

Enumeration date
04/12/2023
Last updated
04/12/2023
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