Individual
MICHELLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3644 S JASMINE DR, CHANDLER, AZ 85286-1649
(480) 789-0332
Mailing address
3644 S JASMINE DR, CHANDLER, AZ 85286-1649
(480) 789-0332
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5764
AZ
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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