MEDICARE: MAKAYLA BROOKE MARTIN

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
1	225700000X	Massage Therapist	MT7396	ME

General Provider Information

NPI Number	:	1104772730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLA BROOKE MARTIN

Provider Business Mailing Address
First Line	:	733 ROOSEVELT TRL STE 1
Second Line	:
City	:	WINDHAM
State	:	ME
Zip	:	04062-5286
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	733 ROOSEVELT TRL STE 1
Second Line	:
City	:	WINDHAM
State	:	ME
Zip	:	04062-5286
Country	:	US
Telephone Number	:	207-346-7412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ MAKAYLA BROOKE MARTIN ” Practice Location

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