Individual
MR. RONALD ALAN MARTIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PROGRAM SPONSOR
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
2000872
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000872
—
NJ
Enumeration date
05/18/2021
Last updated
05/18/2021
Update your record
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