Individual
LAYNE C MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ROT
Contact information
Practice address
1263 BENNETT AVE STE 1, BURLEY, ID 83318-2666
(208) 678-9760
Mailing address
563 W 1700 S, OAKLEY, ID 83346-9747
(208) 862-0402
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
05070617
ID
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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