Provider Demographics
NPI:1548708092
Name:THOMAS, MARTYN (DIPAC)
Entity type:Individual
Prefix:MR
First Name:MARTYN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DIPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COMPTON RD
Mailing Address - Street 2:UNIT 24
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3826
Mailing Address - Country:US
Mailing Address - Phone:513-521-5333
Mailing Address - Fax:513-521-5334
Practice Address - Street 1:800 COMPTON RD
Practice Address - Street 2:UNIT 24
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3826
Practice Address - Country:US
Practice Address - Phone:513-521-5333
Practice Address - Fax:513-521-5334
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000032171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist