Individual
ADA B MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1126 HIGHWAY 917 E, LATTA, SC 29565-4123
(843) 319-4133
Mailing address
206 AIRPORT CT STE B, MULLINS, SC 29574-6196
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
43882
SC
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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