Individual
TERRY A MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 W ROSS BLVD, DODGE CITY, KS 67801-7216
(620) 225-2847
(620) 225-7046
Mailing address
915 N 5TH ST, CIMARRON, KS 67835-9262
(620) 855-7208
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
54522
KS
Other
Enumeration date
07/19/2005
Last updated
07/09/2007
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