Individual
MRS. AMANDA STEPHANIE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, MMS
Contact information
Practice address
195 KING AVE, ATHENS, GA 30606-0000
(706) 549-8306
(706) 549-8351
Mailing address
195 KING AVE, ATHENS, GA 30606
(706) 549-8306
(706) 549-8351
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005307
GA
363A00000X
Physician Assistant
Primary
5307
GA
363A00000X
Physician Assistant
PA9104515
FL
Other
Enumeration date
05/16/2008
Last updated
12/29/2011
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