Individual
MRS. ALICE DALE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDMS, RVT
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
72262
—
2471V0105X
Vascular Sonography Radiologic Technologist
Primary
72262
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72262
RDMS,RVT
FL
01
—
H070000
MEDICARE GROUP
KS
Enumeration date
10/19/2007
Last updated
10/19/2007
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