Individual
COLLETTE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 LASALLE RD STE 208, WEST HARTFORD, CT 06107-2311
(860) 906-1289
(860) 906-1269
Mailing address
125 LASALLE RD STE 208, WEST HARTFORD, CT 06107-2311
(860) 906-1289
(860) 906-1269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6253
CT
Other
Enumeration date
08/28/2023
Last updated
09/08/2024
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