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Individual

DANIEL LEE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
2055 N MAIN ST, TOOELE, UT 84074-9819
(435) 843-3670
(435) 833-9844
Mailing address
2055 N MAIN ST, TOOELE, UT 84074-9819
(435) 843-3640
(435) 833-9844

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
347246-1206
UT

Other

Enumeration date
06/16/2006
Last updated
07/08/2007
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