Individual
TIA MARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 E MAIN ST BLDG B, MEDFORD, OR 97504-7448
(541) 210-2006
Mailing address
1005 E MAIN ST BLDG B, MEDFORD, OR 97504-7448
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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