Individual
JIM MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPT,FNP-C,MSN,AEMT
Contact information
Practice address
157 CLINIC AVE, SUITE 201, CARROLLTON, GA 30117-4454
(770) 214-2800
(770) 214-2803
Mailing address
157 CLINIC AVE, SUITE 201, CARROLLTON, GA 30117-4454
(770) 214-2800
(770) 214-2803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN112921
GA
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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