Provider Demographics
NPI:1558403303
Name:MARTIN-MUELLER, CHRISTINE CHANTAL
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:CHANTAL
Last Name:MARTIN-MUELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:CHANTAL
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:4 JASON ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW GLOUCESTER
Mailing Address - State:ME
Mailing Address - Zip Code:04260
Mailing Address - Country:US
Mailing Address - Phone:207-926-4658
Mailing Address - Fax:
Practice Address - Street 1:49 PINELAND DR
Practice Address - Street 2:SUITE 302A
Practice Address - City:NEW GLOUCESTER
Practice Address - State:ME
Practice Address - Zip Code:04260-5119
Practice Address - Country:US
Practice Address - Phone:207-688-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MENP#300175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath