Individual
MR. SAMUEL KEITH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
4135 FRANKLIN RD, ROANOKE, VA 24018-5703
(540) 776-2933
(540) 776-2932
Mailing address
4135 FRANKLIN RD, ROANOKE, VA 24018-5703
(540) 776-2933
(540) 776-2932
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101001434
VA
156FX1800X
Optician
1129
NC
Other
Enumeration date
02/03/2007
Last updated
11/26/2007
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