Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 14-1459 | AZ |
N | 175F00000X | Naturopath | NT 60523171 | WA |
NPI | 1003205659 |
---|---|
Provider Name | Lindsay Martin |
First Address | Prescott, AZ 86301-3000 |
Second Address | Prescott, AZ 86301-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2015 |
Last Update Date | 06/10/2016 |