Individual
LAKESHIA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4303 WOLF RUN DR, GREENSBORO, NC 27406-8094
(336) 862-3754
Mailing address
203 E MAIN ST UNIT 1192, JAMESTOWN, NC 27282-0166
(336) 862-3754
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
JFC3609
NC
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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