Individual
MICHAEL MARTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5404 SW LEE BLVD, LAWTON, OK 73505-9695
(580) 355-5242
(580) 355-5245
Mailing address
PO BOX 2309, LAWTON, OK 73502-2309
(580) 355-5242
(580) 355-5245
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
85109
OK
Other
Enumeration date
09/13/2006
Last updated
01/12/2016
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