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General NPI Number Information
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NPI Number | 1306660055
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Entity Type | Individual
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Provider Name | FRANK PAUL MARTINEZ
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Gender | Male
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 2827 FORT MISSOULA RD
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City | MISSOULA
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State | MT
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Zip | 59804-7408
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Country | US
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Telephone | 406-728-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 655 S WILLOW ST STE 128
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City | MANCHESTER
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State | NH
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Zip | 03103-5723
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Country | US
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Telephone | 800-995-2673
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 1176845
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License Number State | AZ
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