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General NPI Number Information
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NPI Number | 1588392997
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Entity Type | Organization
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Legal Business Name | MAR-TIN ENTERPRISES LLC
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 310 W MARTIN ST UNIT 8
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City | ELMA
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State | WA
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Zip | 98541-9129
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Country | US
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Telephone | 360-915-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 310 W MARTIN ST UNIT 8
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City | ELMA
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State | WA
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Zip | 98541-9129
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Country | US
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Telephone | 360-915-5335
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. HEATHER TINDER
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Credential |
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Telephone | 951-818-7904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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