Individual
BOBBIE SHANE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
17273 STATE ROUTE 104, CHILLICOTHE VA MEDICAL CENTER, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
715 AUTUMN DR UNIT A, ADA, OH 45810-1830
(419) 634-0776
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
032264202
OH
Other
Enumeration date
08/08/2011
Last updated
08/08/2011
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