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MARTAVIS ISAAC
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1306415468
Individual Registrant: MARTAVIS ISAAC
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
130 OAK ST SOPERTON, GA 30457-2736 US
Tel: 478-290-7167 Fax: --
Tel: 478-290-7167 Fax: --
Contact information for business:
130 OAK ST SOPERTON, GA 30457-2736 US
Tel: 478-290-7167 Fax: --
Tel: 478-290-7167 Fax: --
Registration Information:
NPI: 1306415468
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
