ALEXANDER BLAKE MARTINCIC DURBIN

ALTON, IL
NPI1457112716
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2024-01-23
Last Update Date2024-11-04
Business Address
ALEXANDER BLAKE MARTINCIC DURBIN BA
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
Mailing Address
ALEXANDER BLAKE MARTINCIC DURBIN BA
902 W MAIN ST
WEST FRANKFORT, IL 62896-2210
Phone number: 618-937-6483
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