Individual
DANIELLE D MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
848 N CHURCH RD, LACONA, NY 13083-4158
(315) 391-2899
Mailing address
848 N CHURCH RD, LACONA, NY 13083-4158
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
259352-1
NY
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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