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General NPI Number Information
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NPI Number | 1609099829
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Entity Type | Individual
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Provider Name | AMANDA STARR MARTIN D.C.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 912 SAVANNAH HWY
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City | CHARLESTON
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State | SC
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Zip | 29407-7802
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Country | US
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Telephone | 843-225-4080
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Fax | 843-225-5210
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Provider Business Mailing Address
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Address Line | 997 JOHNNIE DODDS BLVD APT 926
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City | MT PLEASANT
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State | SC
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Zip | 29464-6120
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Country | US
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Telephone | 843-425-8426
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Fax | 843-225-5210
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3130
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License Number State | SC
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