Provider Demographics
NPI:1023442084
Name:MARTIN, KAYLA E (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:KAYLA
Other - Middle Name:ELIZABETH
Other - Last Name:VANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:MARSHFIELD MEDICAL CENTER NEILLSVILLE
Mailing Address - Street 2:N3708 RIVER AVENUE
Mailing Address - City:NEILLSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54456-7218
Mailing Address - Country:US
Mailing Address - Phone:715-819-8274
Mailing Address - Fax:715-743-6242
Practice Address - Street 1:MARSHFIELD MEDICAL CENTER NEILLSVILLE
Practice Address - Street 2:N3708 RIVER AVENUE
Practice Address - City:NEILLSVILLE
Practice Address - State:WI
Practice Address - Zip Code:54456-7218
Practice Address - Country:US
Practice Address - Phone:715-819-8274
Practice Address - Fax:715-743-6242
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013028746225100000X
WI13529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist