Individual
ALLYSON MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-5000
Mailing address
17 COLVINTOWN RD, COVENTRY, RI 02816-8507
(401) 369-0590
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9592
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110201929A
—
MA
Enumeration date
04/27/2023
Last updated
04/04/2024
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