Organization
MARTIC ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN MARTIC CRNA (PRESIDENT)
(701) 340-6220
Entity
Organization
Contact information
Practice address
933 SELL AVE, CANON CITY, CO 81212-4929
(719) 275-6433
(952) 442-3620
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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