Individual
MYRNA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 BOULDER RD, COLCHESTER, CT 06415-2435
(860) 447-2957
Mailing address
2 BOULDER RD, COLCHESTER, CT 06415-2435
(860) 447-2957
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000192
CT
Other
Enumeration date
10/10/2008
Last updated
10/10/2008
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