Individual provider · NPI-1

Edin Martinez

Contractor · Glendale, AZ

NPI number1023211711
StatusActive
Last updated in NPPESAug 7, 2007

Details

NPI
1023211711
Entity type
Individual (NPI-1)
Name
Mr. Edin Martinez
Sex
Male
Sole proprietor
No
Enumeration date
Jun 8, 2007
Last updated
Aug 7, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171W00000X Contractor9305AZYes

Practice location

5425 N 80th Ln
Glendale, AZ 85303-5517

Phone 623-872-9122

Mailing address

5425 N 80th Ln
Glendale, AZ 85303-5517

Phone 623-872-9122

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