MEDICARE: DR. KAYLA MARTIN DC

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	111N00000X	Chiropractor	CHIR010381	GA

General Provider Information

NPI Number	:	1952926644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAYLA MARTIN DC

Provider Business Mailing Address
First Line	:	299 CANTON RD
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-2303
Country	:	US
Telephone Number	:	770-889-2208
Fax Number	:

Provider Business Practice Location Address
First Line	:	299 CANTON RD
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-2303
Country	:	US
Telephone Number	:	770-889-2208
Fax Number	:

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

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	06/09/2020

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