Individual
JEROME MARTISANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
235 ELM ST NE, ALBUQUERQUE, NM 87102-3672
(505) 842-5550
Mailing address
801 LOCUST PL NE, #1206, ALBUQUERQUE, NM 87102-1651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4016
NM
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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