Provider Demographics
NPI:1134523905
Name:JULIE ANN MARTIN CHIROPRACTIC AND REHABILITATION, INC.
Entity type:Organization
Organization Name:JULIE ANN MARTIN CHIROPRACTIC AND REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-268-2273
Mailing Address - Street 1:2909 RICHMOND RD
Mailing Address - Street 2:STE. 120
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1764
Mailing Address - Country:US
Mailing Address - Phone:859-268-2273
Mailing Address - Fax:859-266-0478
Practice Address - Street 1:2909 RICHMOND RD
Practice Address - Street 2:STE. 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1764
Practice Address - Country:US
Practice Address - Phone:859-268-2273
Practice Address - Fax:859-266-0478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85041648Medicaid
KYU29297Medicare UPIN
KY85041648Medicaid