Individual
MR. LARRY GENE MARTINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
201 E STATE ST, HERKIMER, NY 13350-2389
(315) 574-2300
(315) 574-2310
Mailing address
201 E STATE ST, HERKIMER, NY 13350-2389
(315) 574-2300
(315) 574-2310
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03798161
—
NY
Enumeration date
11/22/2005
Last updated
12/06/2019
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