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Individual

MR. EDWARD L MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MLT-ASCP

Contact information

Practice address
5901 BROKEN SOUND PKWY, STE. 500, BOCA RATON, FL 33487-2773
(561) 367-1175
(561) 892-3234
Mailing address
15 JOHN DR, ALAMOGORDO, NM 88310-9545
(505) 434-3139

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
MLT-51881
NM

Other

Enumeration date
09/19/2007
Last updated
09/19/2007
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