Individual ProviderMartin Maurus KidwellAcupuncturistOther Service ProvidersPractice Address685 Portland Ave, Gladstone, OR 97027-2117(503) 891-2352PECOS EnrollmentBased on the most recent information from CMS, provider Martin Maurus Kidwell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:46 AM.Profile DetailsProvider ID1508999061Provider TypeIndividualFull NameKidwell, Martin MaurusCredentialDAOM, L.AC.GenderMaleSole ProprietorYesEnumeration Date3/13/2007Last Updated4/5/2024Contact InformationPractice LocationPractice Address685 Portland Ave, Gladstone, OR 97027-2117Phone(503) 891-2352Fax(503) 655-2146Mailing LocationMailing Address5240 SE King George Ct, Milwaukie, OR 97267-6132Phone(503) 891-2352FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicenseAC01116Oregon