Individual
MARIE B MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
514 IDAHO DRIVE, MEDICINE BOW, WY 82329-0037
(307) 379-2222
(307) 279-2223
Mailing address
PO BOX 124, MEDICINE BOW, WY 82329-0124
(307) 378-2543
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
169
WY
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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