Individual
MR. BRADLEY EUGENE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAPS
Contact information
Practice address
8414 MEADOW GREEN WAY, GAITHERSBURG, MD 20877-3741
(540) 476-4503
(301) 330-1306
Mailing address
8414 MEADOW GREEN WAY, GAITHERSBURG, MD 20877-3741
(540) 476-4503
(301) 330-1306
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
101960
MD
171WH0202X
Home Modifications Contractor
Primary
2705137380
VA
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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