Most Relevant Information
Provider Data
| NPI Number: | 1003303751 |
| Provider Name: | LARA MARTINEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 207P00000X |
| Specialty: | Emergency Medicine |
| License Number: | 34.014062 |
Most Important Dates
| Enumeration Date: | 04/18/2018 |
| Last Updated: | 06/24/2022 |
Provider Practice Location
405 W GRAND AVE
DAYTON
OH
454057538
Practice Location Phone/Fax
| Phone: | 9377233245 |
| Fax: |
Provider Mailing Location
405 W GRAND AVE
DAYTON
OH
454057538
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |