Individual
AMANDA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
995 SW 34TH ST, LEES SUMMIT, MO 64082-4093
(816) 525-4700
Mailing address
1425 NW BLUE PKWY, LEES SUMMIT, MO 64086-5705
(816) 524-5600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2017016526
MO
Other
Enumeration date
04/15/2014
Last updated
03/17/2018
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