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General NPI Number Information
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NPI Number | 1346360278
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Entity Type | Individual
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Provider Name | KELLY ANN MARTIN D.C.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 118 SUMMER ST
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City | TAUNTON
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State | MA
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Zip | 02780-3435
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Country | US
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Telephone | 508-821-3872
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GARDEN ST
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City | EAST TAUNTON
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State | MA
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Zip | 02718-1022
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Country | US
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Telephone | 508-341-9868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1893
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License Number State | MA
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