Vivian L Martin
Vivian L Martin is a Prosthetic/Orthotic Supplier in Mount Vernon, Illinois. Registered with an NPI since 2012.
- In the registry since
- 2012
Practice location Address checks out
1024 Jordan StMount Vernon, IL 62864-4231
Phone: (618) 242-4442
Fax: (618) 242-3942
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Prosthetic/Orthotic Supplier (primary) | Taxonomy 335E00000X |
|---|
Record details
| NPI number | 1194078816 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Vivian Martin — Owner · (618) 242-4442 |
| Other names | Parkway Shoe Repair Service |
| NPI enumerated | October 18, 2012 |
| Last updated in NPPES | October 18, 2012 |
| Mailing address | 1024 Jordan St, Mount Vernon, IL 62864-4231 |