Individual
LAKEISHA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 N RAILROAD AVE STE C, ESPANOLA, NM 87532-3159
(505) 747-8187
(505) 747-8306
Mailing address
1227 N RAILROAD AVE STE C, ESPANOLA, NM 87532-3159
(505) 747-8187
(505) 747-8306
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT00010014
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265683049
—
NM
Enumeration date
03/23/2018
Last updated
03/23/2018
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