Individual
MARY ELIZABETH MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2930 COUNTY ROAD 4002, HOLTS SUMMIT, MO 65043-2079
(573) 295-6684
(573) 295-6684
Mailing address
2930 CO.RD.4003, HOLTS SUMMIT, MO 65043
(573) 295-6684
(573) 295-6684
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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