Provider Demographics
NPI:1154577864
Name:MARTIN, RHONDA LYNN (LICENSED OPTICIAN)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:LYNN
Last Name:MARTIN
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Gender:F
Credentials:LICENSED OPTICIAN
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Mailing Address - Street 1:122 STONE TRACE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MT. STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353
Mailing Address - Country:US
Mailing Address - Phone:859-497-2117
Mailing Address - Fax:859-497-2542
Practice Address - Street 1:122 STONE TRACE DR
Practice Address - Street 2:SUITE B
Practice Address - City:MT. STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353
Practice Address - Country:US
Practice Address - Phone:859-497-2117
Practice Address - Fax:859-497-2542
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYKY-1293156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician