Individual
THOR MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
619 HERRELL RD, VILLA RICA, GA 30180-4544
(770) 615-6376
Mailing address
100 COTTAGE CLUB DR SW UNIT 107, CARTERSVILLE, GA 30120-5534
(706) 802-9960
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN312271
GA
Other
Enumeration date
03/17/2026
Last updated
03/17/2026
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