Individual
MR. KENNETH MICHAEL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4177 S ARCHER AVE, CHICAGO, IL 60632-1849
(773) 254-2222
Mailing address
4177 S ARCHER AVE, CHICAGO, IL 60632-1849
(773) 254-2222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38010989
IL
Other
Enumeration date
07/03/2007
Last updated
02/10/2009
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