Individual
VIVIAN JACQUELINE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2321 MARLENE AVE, KINGMAN, AZ 86401-6433
(928) 234-1857
Mailing address
2321 MARLENE AVE, KINGMAN, AZ 86401-6433
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN207971
AZ
Other
Enumeration date
05/11/2026
Last updated
05/11/2026
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