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General NPI Number Information
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NPI Number | 1043560139
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Entity Type | Organization
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Legal Business Name | MARTHA M MASTERS
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Dates
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Enumeration Date | 09/15/2012
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Last Update Date | 03/09/2018
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Provider Practice Location Address
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Address Line | 301 E 1ST NORTH ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-4711
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Country | US
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Telephone | 423-839-0670
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Fax |
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Provider Business Mailing Address
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Address Line | 301 E 1ST NORTH ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-4711
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Country | US
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Telephone | 423-231-5978
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTHA MASTERS
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Credential | CFM
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Telephone | 423-839-0670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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