Individual
TARA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 WARREN ST APT 2, MANKATO, MN 56001-4689
(507) 420-0105
Mailing address
1102 WARREN ST APT 2, MANKATO, MN 56001-4689
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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