Provider Demographics
NPI:1659600971
Name:KAITON, MARTHA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:MARIE
Last Name:KAITON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 GREENTREE LN NE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9793
Mailing Address - Country:US
Mailing Address - Phone:818-448-3523
Mailing Address - Fax:
Practice Address - Street 1:555 GREENTREE LN NE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9793
Practice Address - Country:US
Practice Address - Phone:818-448-3523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28676225100000X
MI5501020010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist