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Organization
MARTY CLINIC PA
Active
Organization
MARTY CLINIC PA
Active
Other names
Marty Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MARTYELDRIDGE D.C. (CHIROPRACTOR)
(952) 920-9721
Entity
Organization
Contact information
Practice address
5201 EDEN AVE, SUITE 190, EDINA, MN 55436-2316
(952) 920-9721
(952) 241-4355
Mailing address
5201 EDEN AVE, SUITE 190, EDINA, MN 55436-2316
(952) 920-9721
(952) 241-4355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1566
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021527900
—
MN
Enumeration date
05/27/2006
Last updated
06/08/2009
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