Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 35.026388 | OH |
Y | 213EG0000X | General Practice | 35.026388 | OH |
NPI | 1003444241 |
---|---|
Provider Name | Kelsey Lynn Martinez |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2020 |
Last Update Date | 09/06/2021 |