Jeremy Glen Marty, D.C. Valid NPI
Individual provider · Chiropractor · Lakeville, MN
- NPI
- 1104283928
- Type
- Individual (Type 1)
- Primary specialty
- Chiropractor
- Specialty group
- Chiropractic Providers
- Taxonomy code
- 111N00000X
- License number
- 6189 (MN)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2016-01-25
- Last updated
- 2016-10-24
Practice location
18476 Kenrick Ave, Suite 201
Lakeville, MN 55044-9288
(612) 440-5776