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1871002659
SAMUEL MARTINEZ
FORT WAYNE, IN
NPI
1871002659
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: IN 86049228)
Enumeration Date
2017-09-25
Last Update Date
2022-07-21
Business Address
SAMUEL MARTINEZ RD
11109 PARKVIEW PLAZA DR.
FORT WAYNE, IN 46846
Phone number: 260-266-2593
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Mailing Address
SAMUEL MARTINEZ RD
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845-1701
Phone number: 260-266-2593
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