Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIRO07474 | GA |
NPI | 1003117870 |
---|---|
Provider Name | Mrs. Claudia Liliana Martinez |
First Address | Hinesville, GA 31313 |
Second Address | Hinesville, GA 31313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2010 |
Last Update Date | 10/11/2010 |