| Don V Martin Llc | |
|
8472 Lake Shore Blvd Mentor OH 44060-1515 | |
| (330) 518-8676 | |
| (724) 371-0586 |
| Full Name | Don V Martin Llc |
|---|---|
| Speciality | Psychologist |
| Location | 8472 Lake Shore Blvd, Mentor, Ohio |
| Authorized Official Name and Position | Donald V Martin (OWNER) |
| Authorized Official Contact | 3305188676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Don V Martin Llc Po Box 327 Girard OH 44420-0327 Ph: (330) 518-8676 | Don V Martin Llc 8472 Lake Shore Blvd Mentor OH 44060-1515 Ph: (330) 518-8676 |
| NPI Number | 1710156435 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 01/28/2015 |
| Medicare PECOS PAC ID | 1557440526 |
|---|---|
| Medicare Enrollment ID | O20080501000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710156435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 5695 (Ohio) | Primary |
| Provider Name | Don Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801837018 PECOS PAC ID: 0244258937 Enrollment ID: I20051110001003 |
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