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Individual
MR. KELLY H MARTIN
Active
Individual
MR. KELLY H MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT,ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5264
MS
2255A2300X
Athletic Trainer
AT0461
MS
Other
Enumeration date
05/24/2012
Last updated
07/21/2014
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