Individual
KATHLEEN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 S BAILEY AVE STE 1, SOUTH HAVEN, MI 49090-8744
(269) 639-2866
Mailing address
601 JOHN STREET, BOX 39, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010089
MI
Other
Enumeration date
11/08/2019
Last updated
06/16/2021
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