Individual
MARTHA A PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AP
Contact information
Practice address
1216 13TH AVE W, BRADENTON, FL 34205-7345
(941) 744-9770
Mailing address
1216 13TH AVE W, BRADENTON, FL 34205-7345
(941) 744-9770
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP1663
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0790
BCBS OON PROVIDER NUMBER
FL
01
—
COOTT
FLORIDA BLUE
FL
Enumeration date
05/03/2006
Last updated
01/30/2015
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