Individual
MARTINA CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CR, LMT
Contact information
Practice address
1519 NW SMITH AVE, LAWTON, OK 73507-2648
(580) 583-2739
Mailing address
1519 NW SMITH AVE, LAWTON, OK 73507-2648
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
OK
225700000X
Massage Therapist
Primary
MT113631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
616546600
DOL
OK
Enumeration date
07/20/2012
Last updated
08/15/2012
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