Individual
KELLY RENEE' MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
220 WEST MAIN STREET, KINGWOOD, WV 26537
(304) 329-3600
(304) 329-3356
Mailing address
563 PLEASANTDALE ROAD, KINGWOOD, WV 26537
(304) 329-3772
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005794
WV
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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