Individual
MR. BRUCE S MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
712 RUTGER ST, UTICA, NY 13501-2508
(315) 272-6367
Mailing address
712 RUTGER ST, UTICA, NY 13501-2508
(315) 272-6367
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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