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NPI Code Detail

MEDICARE: MARTIN JI

MEDICARE:   MARTIN  JI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1477405447
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN JI
Provider Business Mailing Address
First Line : 6013 S REDWOOD RD
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-5220
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 35 SKYLINE DR
Second Line :
City : BRIGHAM CITY
State : UT
Zip : 84302-6772
Country : US
Telephone Number : 801-255-5131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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Directions to “ MARTIN JI ” Practice Location

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