MEDICARE: DR. KATINA LYNN MARTIN N.D., L.AC.

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	171100000X	Acupuncturist	091-0000179	VT
2	175F00000X	Naturopath	099-0000182	VT

General Provider Information

NPI Number	:	1346373719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATINA LYNN MARTIN N.D., L.AC.

Provider Business Mailing Address
First Line	:	111 MAPLE ST STE 17
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-4444
Country	:	US
Telephone Number	:	802-352-9078
Fax Number	:	802-352-9008

Provider Business Practice Location Address
First Line	:	111 MAPLE ST STE 17
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-4444
Country	:	US
Telephone Number	:	802-352-9078
Fax Number	:	802-352-9008

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	06/12/2023

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