| NPI | 1043761133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY GLEN MARTY Owner/Chiropractor 612-440-5776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 6189) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |