Most Relevant Information
Provider Data
| NPI Number: | 1003273442 |
| Provider Name: | ELDA MARIN |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/15/2016 |
| Last Updated: | 01/15/2016 |
Provider Practice Location
502 SW 38TH ST
LAWTON
OK
735056921
Practice Location Phone/Fax
| Phone: | 5802502600 |
| Fax: | 5803551211 |
Provider Mailing Location
502 SW 38TH ST
LAWTON
OK
735056921
Provider Mailing Phone/Fax
| Phone: | 5802502600 |
| Fax: | 5803551211 |