Healthcare Provider Details

I. General information

NPI: 1548708092
Provider Name (Legal Business Name): MARTYN THOMAS DIP.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2017
Last Update Date: 02/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COMPTON RD UNIT 24
CINCINNATI OH
45231-3826
US

IV. Provider business mailing address

800 COMPTON RD UNIT 24
CINCINNATI OH
45231-3826
US

V. Phone/Fax

Practice location:
  • Phone: 513-521-5333
  • Fax: 513-521-5334
Mailing address:
  • Phone: 513-521-5333
  • Fax: 513-521-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000032
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: