Individual
MRS. SUSAN MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2200 W KIMBERLY RD, DAVENPORT, IA 52806-5300
(563) 391-1543
(563) 391-9117
Mailing address
1222 E DOVER CT, DAVENPORT, IA 52803-1943
(563) 210-1600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19113
IA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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