MARK RANDALL MARTIN

BLOOMINGTON, IL
NPI1467563205
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: IL  180-003310)
Enumeration Date2006-08-31
Last Update Date2007-07-08
Business Address
Mr. MARK RANDALL MARTIN L.C.P.C.
1505 EASTLAND DR EMP II LL 1000
BLOOMINGTON, IL 61701-3534
Phone number: 309-663-1623
Mailing Address
Mr. MARK RANDALL MARTIN L.C.P.C.
45 BROOKSHIRE GRN
BLOOMINGTON, IL 61704-6211
Phone number: 309-663-8243
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