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1740949247
IAN ROTH MARTIN
PORTLAND, OR
NPI
1740949247
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-12-12
Last Update Date
2021-12-12
Business Address
IAN ROTH MARTIN
121 SW SALMON ST FL 11
PORTLAND, OR 97204-2908
Phone number: 855-832-6727
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Mailing Address
IAN ROTH MARTIN
7108 S KANNER HWY
STUART, FL 34997-7462
Phone number: 855-832-6727
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