Individual
JUSTIN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-4660
Mailing address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17716-40
WI
Other
Enumeration date
04/21/2016
Last updated
08/23/2022
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