Healthcare Provider Details

I. General information

NPI: 1134747058
Provider Name (Legal Business Name): ABBIE LOUISE MARTIN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 HOOKSETT RD STE B1
HOOKSETT NH
03106-1882
US

IV. Provider business mailing address

1461 HOOKSETT RD STE B1
HOOKSETT NH
03106-1882
US

V. Phone/Fax

Practice location:
  • Phone: 603-669-2043
  • Fax:
Mailing address:
  • Phone: 603-669-2043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1016
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: