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General NPI Number Information
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NPI Number | 1184440232
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Entity Type | Individual
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Provider Name | ELEANOR CHERIE MARTIN LDO/ABO
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 2448 CHESAPEAKE SQUARE RING RD
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2173
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Country | US
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Telephone | 757-488-6916
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Fax | 757-465-2030
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Provider Business Mailing Address
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Address Line | 2401 BALLAHACK RD
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City | CHESAPEAKE
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State | VA
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Zip | 23322-2860
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Country | US
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Telephone | 757-342-8580
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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