Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | NAT296 | DC |
NPI | 1124267430 |
---|---|
Provider Name | Dr. Dan L Martin |
First Address | Texarkana, AR 71854-5323 |
Second Address | Texarkana, AR 71854-5323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2009 |
Last Update Date | 10/02/2009 |