Male or Other

Mr. Samuel K. Martin LDO

Optician in Roanoke, VA(View on Map)

Full Name

Mr. Samuel Keith Martin LDO

NPI Number

1730227349

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/03/2007

Specialties

(Taxonomies)

Code

156FX1800X

Primary Taxonomy

Yes

Licenses

State

North Carolina
Virginia

License Number

1129
1101001434

Contact
Information

Purpose

Mailing
Location

Address

4135 FRANKLIN RD
4135 FRANKLIN RD

City

Roanoke
Roanoke

State

VA
VA

Postal Code

24018-5703
24018-5703

Country

US
US

Telephone Number

(540) 776-2933
(540) 776-2933

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/26/2007

Provider Address

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