Healthcare Provider Details

I. General information

NPI: 1730083262
Provider Name (Legal Business Name): MARTINA LATRICE FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27249 FLORENCE ST
INKSTER MI
48141-2511
US

IV. Provider business mailing address

27249 FLORENCE ST
INKSTER MI
48141-2511
US

V. Phone/Fax

Practice location:
  • Phone: 888-360-9355
  • Fax:
Mailing address:
  • Phone: 888-360-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: