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General NPI Number Information
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NPI Number | 1932640471
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Entity Type | Individual
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Provider Name | KATHRYN CLOWER MARTINE D.C
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Gender | Female
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 36468 EMERALD COAST PKWY STE 11101
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City | DESTIN
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State | FL
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Zip | 32541-0741
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Country | US
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Telephone | 850-460-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 36468 EMERALD COAST PKWY STE 11101
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City | DESTIN
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State | FL
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Zip | 32541-0741
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Country | US
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Telephone | 850-460-2085
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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 | CH11791
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License Number State | FL
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