Provider Demographics
NPI:1003205659
Name:MARTIN, LINDSAY (ND)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N CORTEZ ST
Mailing Address - Street 2:STE. 104
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3000
Mailing Address - Country:US
Mailing Address - Phone:928-445-1320
Mailing Address - Fax:928-445-3888
Practice Address - Street 1:107 N CORTEZ ST
Practice Address - Street 2:STE. 104
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3000
Practice Address - Country:US
Practice Address - Phone:928-445-1320
Practice Address - Fax:928-445-3888
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60523171175F00000X
AZ14-1459175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath