Provider Demographics
NPI:1306194345
Name:MARTIN, JULIE SAYLORS
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:SAYLORS
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 LAKEFRONT RD
Mailing Address - Street 2:
Mailing Address - City:TOWNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29689-2507
Mailing Address - Country:US
Mailing Address - Phone:864-760-0626
Mailing Address - Fax:864-947-7739
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:
Practice Address - City:PELZER
Practice Address - State:SC
Practice Address - Zip Code:29669-1503
Practice Address - Country:US
Practice Address - Phone:864-760-0626
Practice Address - Fax:864-947-7739
Is Sole Proprietor?:No
Enumeration Date:2012-08-23
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC009019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist