Individual
CARLY SAGE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
134 MAIN ST, PUTNAM, CT 06260-1920
(860) 377-5311
Mailing address
PO BOX 183, PUTNAM, CT 06260-0183
(860) 377-5311
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
CT
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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