Individual
TRUITT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8312
(907) 631-3520
Mailing address
1401 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8312
(907) 631-3520
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
AK
Enumeration date
06/12/2020
Last updated
06/12/2020
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