Tracy B Martin PA

NPI 1952460057 - Physician Assistant - 363A00000X

NPI Details
NPI 1952460057
Gender Female
Enumeration Date 12/06/2006
Last Updated 08/12/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
800 UNIVERSITY DR
MEDICAL STAFF OFFICE
MARYVILLE MO, 64468-6015, US
Phone (660) 562-1348
Fax (660) 562-1857
Business Location
800 UNIVERSITY DR
MEDICAL STAFF OFFICE
MARYVILLE MO, 64468-6015, US
Phone (660) 562-1348
Fax (660) 562-1857
Toxanomy
Taxonomy Code 363A00000X
License State New Mexico
License Number 99-PA28
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According to our database, Tracy B Martin PA NPI is 1952460057, taxonomy code is 363A00000X and license number is 99-PA28, license state is located at New Mexico. Tracy B Martin PA physically located at 800 University Dr, Maryville MO, 64468-6015. NPI Number Tracy B Martin PA has the Individual type.

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1952460057 NPI number is provided on an as is basis without warranty of any kind. 1952460057 is maintained by the National Plan & Provider Enumeration System. The contents of Tracy B Martin PA are for informational purposes only.