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MARTAVIS ISAAC

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1306415468

Individual Registrant:
 MARTAVIS  ISAAC 
Gender: M
Sole Proprietor

Location and contact information for practice:
130 OAK ST  SOPERTON, GA 30457-2736 US
Tel: 478-290-7167  Fax: --

Contact information for business:
130 OAK ST  SOPERTON, GA 30457-2736 US
Tel: 478-290-7167  Fax: --

Registration Information:
NPI: 1306415468
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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