Individual
ANGELA LAKERSHA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 CYCLORAMA DR, CINCINNATI, OH 45211-8330
(513) 260-0975
Mailing address
2810 CYCLORAMA DR, CINCINNATI, OH 45211-8330
(513) 260-0975
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3116256
OH
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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