Organization
GENTRY MARTIAL ARTS
Active
Organization
GENTRY MARTIAL ARTS
Active
Other names
GMAM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON SIEG (PRESIDENT)
(765) 342-5600
Entity
Organization
Contact information
Practice address
333 W. WASHIGTON ST., MARTINSVILLE, IN 46151-1431
(765) 342-5600
(765) 342-5605
Mailing address
PO BOX 1414, MARTINSVILLE, IN 46151-0414
(765) 342-5600
(765) 342-5605
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200918350 A
—
IN
Enumeration date
01/23/2009
Last updated
01/23/2009
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