NPI 1073667226

Jacqueline Wilson Martin

Practitioner Lodging Provider Reidsville, NC

Practice location

Address: 538 Warriner St, Reidsville, NC 27320-3053
Phone: (336) 348-6902
Mailing address: 210 S van Buren Rd, Eden, NC 27288-5025

Registered specialties

Lodging Provider Primary

Other Service Providers Taxonomy 177F00000X Licence FCL-079-037 (NC)

Other Lodging providers in North Carolina →

Registry record

NPI: 1073667226
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jan 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.