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Ellen Martin
NPI 1902572571 · on the registry since 2021 · sole proprietor
Practice
- Address
- 621 Spring Ct
Random Lake, WI 53075 - Phone
- (920) 960-0505
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-08-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin