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NPI Code Detail

MEDICARE: ELIZABETH MARTIN

MEDICARE:   ELIZABETH  MARTIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1164243663
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARTIN
Provider Business Mailing Address
First Line : 272 W LYNN ST
Second Line :
City : SAINT PARIS
State : OH
Zip : 43072-9214
Country : US
Telephone Number : 937-896-1747
Fax Number :
Provider Business Practice Location Address
First Line : 272 W LYNN ST
Second Line :
City : SAINT PARIS
State : OH
Zip : 43072-9214
Country : US
Telephone Number : 937-896-1747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2024
Last Update Date : 10/18/2024

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Directions to “ ELIZABETH MARTIN ” Practice Location

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