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NPI Code Detail

MEDICARE: DR. GREGORY KYLE MARTIN D.C.

MEDICARE:  DR. GREGORY KYLE MARTIN  D.C.
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
1111N00000XChiropractorCH00034609WA

General Provider Information

NPI Number : 1093824245
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY KYLE MARTIN D.C.
Provider Business Mailing Address
First Line : 460 228TH AVE NE
Second Line :
City : SAMMAMISH
State : WA
Zip : 98074-7209
Country : US
Telephone Number : 425-868-9025
Fax Number : 425-432-1449
Provider Business Practice Location Address
First Line : 460 228TH AVE NE
Second Line :
City : SAMMAMISH
State : WA
Zip : 98074-7209
Country : US
Telephone Number : 142-586-8902
Fax Number : 142-543-2144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GREGORY KYLE MARTIN D.C.” Practice Location

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