Individual
AUTUMN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
554 MAIN RD, CORFU, NY 14036-9534
(315) 727-1171
Mailing address
554 MAIN RD, CORFU, NY 14036-9534
(315) 727-1171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
22667994
NY
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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